新定义下急性胰腺炎液体积聚的临床转归

目的：探讨新定义下急性胰腺炎（AP）液体积聚的临床转归。方法回顾分析2009年9月至2013年12月我院收治的522例 AP 患者的临床资料，依照新定义进行液体积聚的分类， Logistic 回归分析影响液体积聚吸收的危险因素。结果522例资料完整的 AP 患者中，238例患者出现液体积聚，发生率45．6％，其中145例（60．9％，145/238）于4周内吸收，继发感染率约31．9％。酒精性胰腺炎（OR 1．16，95％CI 1．02～1．93）、APACHEⅡ评分≥8分（OR 3．21，95％CI 2．82～5．91）、血清 Na ＋水平≥145 mmol/L（OR 2．14，95％CI 1．88～2．91）、CT 提示胰腺坏死（OR 5．30，95％CI 11．35～33．18）、脓毒症（OR 13．5，95％CI 10．22～18．95）是影响液体积聚吸收的独立危险因素。结论新定义下，液体积聚仍是 AP 的常见并发症，其结局与胰腺炎病因及严重程度有关。

Clinical outcome of fluid accumulation for acute pancreatitis under new definition

Objective To explore the clinical outcomes of fluid accumulation for acute pancreati-tis（AP）under new Atlanta definition.Methods The clinical data from 522 AP patients who admitted to our hospital between September 2009 and December 2013 were retrospectively analyzed.The fluid accumu-lation was classified according to the new Atlanta definition.Risk factors for fluid accumulation and absorp-tion were analyzed with logistic regression analysis.Results The incidence of fluid accumulation in AP patients was 45.6%（238 /522）.Among patients with fluid accumulation,self-absorbtion happened in 145 patients（60.9%,145 /238）and subsequent infection occurred in 31.9% of the patients.Logistic regres-sion analysis revealed that alcoholic etiology（OR 1.16,95%CI 1.02 ~1.93）,APACHEⅡscore≥8（OR 3.21,95%CI 2.82 ~5.91）,level of serum sodium ≥145mmol/L（OR 2.14,95%CI 1.88 ~2.91）,pan-creatic necrosis revealed by CT（OR 15.30,95%CI 11.35 ~33.18）and sepsis（OR 13.5,95%CI 10.22~18.95）were the independent predictors of fluid accumulation.Conclusion Fluid accumulation is still a common complication of acute pancreatitis even under the new definition.The clinical outcomes of fluid ac-cumulation are related to the cause and severity of acute pancreatitis.