血糖测定在重症急性胰腺炎合并腹腔感染患者中的临床研究

Clinical research of blood glucose measurement in severe acute pancreatitis patients with abdominal infection

目的探讨重症急性胰腺炎(severe acute pancreatitis,SAP)合并腹腔感染(intra-abdominal infection,IAI)患者住院期间血糖水平及变异性的临床特点及其对SAP合并IAI预后的影响。方法收集我院2018年7月至2020年5月收治的120例SAP患者为研究对象,按是否合并IAI及住院期间血糖测定值分为三组:SAP无IAI组(n=60)、SAP合并IAI血糖异常组(n=30)、SAP合并IAI血糖正常组(n=30),其中血糖平均值≥11.1 mmol/L为血糖异常组。回顾性分析患者临床资料,记录患者腹腔病原菌感染状况,并对各组ICU监护时间、住院时间、死亡人数等数据进行计算。结果SAP合并IAI血糖异常组较SAP无IAI组、SAP合并IAI血糖正常组的血糖平均值偏高、变异性大(P<0.05),同时其住院时间、ICU监护时间均长于另外两组(P<0.05),然而合并IAI患者两组在死亡率方面差异无统计学意义(P>0.05)。结论血糖水平偏高和血糖变异性大对SAP合并IAI患者产生不利临床影响,是其预后不良的指标。

Objective To investigate the clinical features and prognosis of blood glucose levels and variability during hospitalization in severe acute pancreatitis(SAP)patients with intra-abdominal infection(IAI).[WTHZ]Methods SAP patients(n=120)admitted to our hospital from Jul.2018 to May 2020 were studied.According to whether or not they had IAI and blood glucose measurement during hospitalization,they were divided into 3 groups:SAP without IAI group(n=60),SAP with IAI of abnormal blood glucose group(n=30),SAP with IAI of normal blood glucose group(n=30),in which the mean blood glucose≥11.1 mmol/L was the abnormal blood glucose group.The clinical data of patients were retrospectively analyzed,and the pathogens of abdominal infection were recorded.The data of ICU monitoring time,hospitalization days and deaths were calculated and analyzed.[WTHZ]Results SAP with IAI of abnormal blood glucose group compared with SAP without IAI group,SAP with IAI of normal blood glucose group,the mean blood glucose was high,variability(P<0.05),and the length of hospital stay,ICU monitoring time were longer than the other two groups(P<0.05).However,there was no significant difference in mortality between the two groups patients with IAI(P>0.05).[WTHZ]Conclusion High glucose levels and blood glucose variability have adverse clinical effects on SAP patients with IAI,and are indicators of poor prognosis.