重症急性胰腺炎并发内脏静脉血栓的危险因素分析

Analysis on risk factors of severe acute pancreatitis complicatingsplanchnic venous thrombosis

目的探讨重症急性胰腺炎(SAP)并发内脏静脉血栓(SVT)的危险因素,以指导临床进行早期预防。方法选取2018年1月至2022年12月该院收治的173例SAP患者,根据住院期间是否并发SVT分为未并发SVT组(n=143)、并发SVT组(n=30)。收集患者一般资料及各类临床治疗检查相关资料,多因素logistic回归分析SAP并发SVT的危险因素。结果两组休克(P<0.001)、胰腺囊肿(P=0.002)、气管插管(P<0.001)、肾功能异常(P=0.014)比例,以及总胆红素(P=0.049)、直接胆红素(P=0.018)、AST(P=0.011)、降钙素原(P=0.021)、凝血酶时间(P=0.024)、D-二聚体(P=0.003)、MCTSI评分(P<0.001)、APACHEⅡ评分(P<0.001)比较差异有统计学意义。多因素logistic回归分析显示,有胰腺囊肿(OR=2.700,95%CI:1.022~7.134,P=0.045)、APACHEⅡ评分升高(OR=1.137,95%CI:1.002~1.290,P=0.047)是SAP并发SVT的独立危险因素。结论有胰腺囊肿、APACHEⅡ评分升高是SAP并发SVT的独立危险因素,需要对患者密切随访并及时干预治疗。

Objective To investigate the risk factors of complicating splanchnic venous thrombosis(SVT)in severe acute pancreatitis(SAP)in order to guide clinic for conducting early prevention.Methods A total of 173 patients with SAP admitted and treated in this hospital from January 2018 to December 2022 were selected and divided into the non-complicating SVT group(n=143)and complicating SVT group(n=30)according to whether having secondary SVT or not.The general data and various clinical treatment and examination-related data were collected.The multi-factor logistic regression was used to analyze the risk factors of complicating SVT in SAP.Results Shock(P<0.001),pancreatic cyst(P=0.002),tracheal intubation(P<0.001),proportion of abnormal renal function(P=0.014),total bilirubin(P=0.049),direct bilirubin(P=0.018),AST(P=0.011),procalcitonin(P=0.021),thrombin time(P=0.024),D-dimer(P=0.003),MCTSI score(P<0.001)and APACHEⅡscore(P<0.001)had statistical difference between the two groups.The multivariate logistic regression analysis showed that pancreatic cyst(OR=2.700,95%CI:1.022-7.134,P=0.045)and APACHEⅡscore increase(OR=1.137,95%CI:1.002-1.290,P=0.047)were the independent risk factors for complicating SVT in SAP.Conclusion Pancreatic cysts and APACHEⅡscore increase are the independent risk factors for complicating SVT in SAP.These patients require close follow-up and timely intervention and treatment.