重症急性胰腺炎恢复期胃瘫的相关危险因素分析

Risk factors for gastric paralysis in patients with severe acute pancreatitis

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)恢复期胃瘫(gastoparesis syndrome,GS)发生的危险因素及防治措施.方法收集甘肃省人民医院普外科2011-01/2016-01共计447例SAP患者的临床资料,通过分析SAP恢复期GS患者的相关资料,应用非条件Logistic回归分析SAP恢复期GS的危险因素.结果24例患者病程后期发生GS,单因素分析显示年龄、性别、体质量指数、后期白蛋白水平、早期肠内营养、早期通里攻下、病程后期血糖水平、焦虑抑郁评分等因素与SAP相关并纳入多因素分析.多因素非条件Logistic逐步回归分析显示:女性、焦虑抑郁是SAP后期GS发生的危险因素,而早期肠内营养、早期通里攻下、病程后期白蛋白水平高者是SAP后期GS发生的保护性因素.结论SAP患者发生GS与性别、焦虑抑郁、早期肠内营养、早期通里攻下、病程后期白蛋白水平等因素有关,早期处理高危因素有助于预防GS的发生.

AIM To identify the risk factors for gastric paralysis（GS） in patients with severe acute pancreatitis（SAP）, in order to improve its diagnosis and therapy. METHODS Clinical data for 447 SAP patients treated from January 2011 to January 2016 at Department of General Surgery, Gansu Provincial Hospital were retrospectively analyzed. Risk factors for GS in SAP patients were identified by nonconditional Logistic regression analysis. RESULTS Univariate analysis showed that age, sex, body mass index（BMI）, protein level, early enteral nutrition（EEN）, early effective Chinese medicine, blood glucose level, scores of anxiety and depression were risk factors for GS in SAP patients. The non-conditional Logistic regression analysis showed that female sex, anxiety and depression were independent risk factors, while EEN, early effective Chinese medicine and high protein level were protective factors for GS in SAP patients. CONCLUSION Female sex, anxiety and depression are risk factors for GS in SAP patients. Earlier management of high-risk factors can help to prevent the occurrence of GS in SAP patients.