重症急性胰腺炎继发胰腺感染的影响因素分析

Analysis of related factors of secondary pancreatic infection in patients with severe acute pancreatitis

目的:分析重症急性胰腺炎继发胰腺感染的影响因素。方法:回顾性分析2018年5月至2020年4月95例重症急性胰腺炎患者的临床资料,根据是否继发胰腺感染将其分为感染组(n=40)与非感染组(n=55),收集两组临床资料,采用单因素和多因素Logistic回归分析重症急性胰腺炎继发胰腺感染的影响因素。结果:重症急性胰腺炎患者的年龄、机械通气时间、入院时白细胞计数(WBC)、有无低氧血症、禁食时间、有无胃肠功能障碍、中心静脉留置导管时间、有无多器官功能衰竭均与继发胰腺感染有关(P<0.05),有无胆源性致病因素、血清白蛋白水平、血淀粉酶水平、血糖水平、急性生理学及慢性健康状况Ⅱ评分均与继发胰腺感染无关(P>0.05);有低血氧症、禁食时间≥15 h、入院时WBC≥20×109/L、中心静脉留置导管时间≥7 d、有胃肠功能障碍均为重症急性胰腺炎患者继发胰腺感染的危险因素(OR>1,P<0.05)。结论:有低血氧症、禁食时间≥15 h、入院时WBC≥20×109/L、中心静脉留置导管时间≥7 d、有胃肠功能障碍均为影响重症急性胰腺炎患者继发胰腺感染的危险因素。

Objective:To analyzed related factors of secondary pancreatic infection in patients with severe acute pancreatitis.Methods:The clinical data of 95 patients with severe acute pancreatitis from May 2018 to April 2020 were retrospectively analyzed.According to whether they had secondary pancreatic infection,they were divided into infected group(n=40)and non-infected group(n=55).The clinical data of the two groups were collected.The influencing factors of secondary pancreatic infection were analyzed by univariate and multivariate regression analysis.Results:The age of the patients with severe acute pancreatitis,duration of mechanical ventilation,white blood cell count(WBC)at admission,presence or absence of hypoxemia,fasting time,gastrointestinal dysfunction,time of central venous indwelling catheter,and presence or absence of multiple organ failure were all related to secondary pancreatic infection(P<0.05).The presence or absence of biliary pathogenic factors,serum albumin levels,blood amylase levels,blood glucose levels,and APACHE II scores were not associated with secondary pancreatic infection(P>0.05).Further,the presence of hypoxemia,fasting time≥15 h,WBC≥20×109/L at admission,central venous catheterization time≥7 days,and gastrointestinal dysfunction were all the risk factors for secondary pancreatic infection in the patients with severe acute pancreatitis(OR>1,P<0.05).Conclusions:The presence of hypoxemia,fasting time≥15 h,WBC≥20×109/L at admission,central venous catheterization time≥7 days,and gastrointestinal dysfunction are all the risk factors for secondary pancreatic infection in the patients with severe acute pancreatitis.