影响急性重症胰腺炎患者死亡的危险因素分析

目的:分析影响急性重症胰腺炎患者死亡的危险因素,为临床防治提供依据。方法:回顾性分析我院2014年11月至2018年10月收治的101例急性重症胰腺炎患者临床资料,根据其治疗结局将其分为生存组(好转出院)82例和死亡组(住院期间死亡)19例,分析影响急性重症胰腺炎患者死亡的危险因素。结果:单因素分析显示:死亡组Ranson评分、急性生理与慢性健康评分(APACHE-II)、CT严重指数(CTSI)、病因、血钙(Ca)、血清白蛋白(ALB)、血糖、血肌酐(Cr)、血尿素氮(BUN)、谷草转氨酶(AST)、上消化道出血发生率、胸腔积液发生率、脓毒血症发生率、休克发生率、多器官功能衰竭发生率与生存组比较差异均有统计学意义(P0.05)。多因素logistic回归分析显示:APACHE-II评分、血糖、Cr、BUN、脓毒血症、休克、多器官功能衰竭是急性重症胰腺炎患者死亡独立危险因素(P0.05),Ca、ALB是其保护因素(P0.05)。结论:影响急性重症胰腺炎患者死亡危险因素包括APACHE-II评分、FPG、Cr、BUN、AST、脓毒血症、休克、多器官功能衰竭,保护因素包括Ca、ALB。

Analysis on Risk Factors Affecting Death in Patients with Acute Severe Pancreatitis

ABSTRACT Objective: To analyze the risk factors affecting death in patients with acute severe pancreatitis, to provide evidences for clinical prevention and treatment. Methods: The clinical data of 101 patients with acute severe pancreatitis who were admitted to the hospital during the period from November 2014 to October 2018 were retrospectively analyzed. According to their treatment outcomes, they were divided into survival group (improved and discharged, n=82) and death group (died during hospitalization period, n=19). The risk factors affecting death in patients with acute severe pancreatitis were analyzed. Results: Univariate analysis showed there were significant differences in Ranson score, scores of Acute Physiology and Chronic Health Evaluation (APACHE-II), CT severity index (CTSI), cause of disease, serum calcium (Ca), serum albumin (ALB), blood glucose, serum creatinine (Cr), blood urea nitrogen (BUN), aspartate aminotransferase (AST), incidence of upper gastrointestinal haemorrhage, pleural effusion, sepsis, shock and multiple organ failure between survival group and death group (P<0.05). Multivariate Logistic regression analysis showed that APACHE-II scores, blood glucose, Cr, BUN, sepsis, shock, and multiple organ failure were independent risk factors for death in patients with acute severe pancreatitis (P<0.05), while Ca and ALB were protective factors (P<0.05). Conclusion: The risk factors affecting death in patients with acute severe pancreatitis include APACHE-II scores, FPG, Cr, BUN, AST, sepsis, shock, and multiple organ failure, while the protective factors include Ca and ALB.