重症急性胰腺炎患者生存质量调查及并发腹腔感染的影响因素分析

Investigation of Quality of Life in Patients with Severe Acute Pancreatitis and Analysis of Influencing Factors of Abdominal Infection

目的:调查重症急性胰腺炎(SAP)患者生存质量,并分析SAP并发腹腔感染的影响因素。方法:选取我院于2017年1月~2019年12月期间收治的136例SAP患者纳入研究组。另选取同期于我院进行体检的健康者90例纳入对照组。研究组中的患者根据腹腔感染情况分为感染组(n=48)和未感染组(n=88)。采用生活质量调查简表(SF-36)对对照组、研究组的生存质量进行评定。SAP并发腹腔感染的影响因素予以单因素及多因素Logistic回归分析。结果:研究组的社会功能、精力、生理职能、情感职能、生理机能、一般健康状况、躯体疼痛、精神健康评分均低于对照组(P<0.05)。单因素分析结果显示:SAP并发腹腔感染与机械通气时间、多器官功能障碍综合征、糖尿病、低氧血症、肠功能障碍时间、肾衰竭、急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ)有关(P<0.05);而与性别、年龄、发病类型、病因、呼吸衰竭无关(P>0.05)。多因素Logistic回归分析结果显示:存在多器官功能障碍综合征、机械通气时间≥10 h、肠功能障碍时间≥4d、存在肾衰竭、存在低氧血症、APACHEⅡ>11分均为SAP并发腹腔感染的危险因素(P<0.05)。结论:与健康者相比,SAP患者的生存质量较低,需要院外持续的健康干预。另SAP患者合并腹腔感染与多种因素相关,应引起临床重视并积极采取相关应对措施,以改善患者预后。

Objective:To investigate the quality of life of patients with severe acute pancreatitis(SAP),and to analyze the influencing factors of SAP complicated with abdominal infection.Methods:136 patients with SAP in our hospital from January 2017 to December 2019 were selected and included in the study group.Another 90 volunteers who had physical examination in our hospital at the same time were selected as the control group.The patients in the study group were divided into infection group(n=48)and non infection group(n=88)according to the abdominal infection situation.Quality of life survey(SF-36)was used to evaluate the quality of life of the control group and the study group.The influencing factors of SAP complicated with abdominal infection were analyzed by univariate and multivariate logistic regression.Results:The scores of social function,energy,physiological function,emotional function,physiological function,general health condition,physical pain and mental health of the study group were lower than those of the control group(P<0.05).Univariate analysis showed that mechanical ventilation time,multiple organ dysfunction syndrome,diabetes mellitus,hypoxemia,intestinal dysfunction time,renal failure,Acute physiology and chronic health status score II(APACHEⅡ)were associated with SAP complicated with abdominal infection(P<0.05),but not with gender,age,type of disease,etiology and respiratory failure(P>0.05).Multivariate Logistic regression analysis showed that multiple organ dysfunction syndrome,mechanical ventilation time≥10 h,intestinal dysfunction time≥4 d,renal failure,hypoxemia,APACHEⅡ>11 points were independent risk factors of SAP complicated with abdominal infection(P<0.05).Conclusion:Compared with healthy patients,patients with SAP have a lower quality of life and required continuous health intervention outside the hospital.In addition,SAP complicated with abdominal infection is associated with many factors,which should be paid attention to clinically and relevant countermeasures should be taken actively to improve the prognosis of patients.