重症急性胰腺炎入院24h内死亡因素剖析

Analysis of factors influencing mortality of severe acute pancreatitis

目的 探讨重症急性胰腺炎死亡因素。方法 应用SPSS10 .0软件对 5 2例重症急性胰腺炎病人入院 2 4h内临床资料进行Logistic回归分析 ,筛选重症急性胰腺炎死亡的危险因素 ,并建立Logistic回归方程式。结果 在调查的 2 7个因素中血pH值、APACHEⅡ评分、早期休克、合并多脏器功能衰竭与死亡关 ;单因素Logistic回归分析发现休克、胸腔积液、血pH值、APACHEⅡ评分以及并发症的发生与死亡有关 ,而多因素分析发现只有血pH值与重症急性胰腺炎的死亡有关。结论 该回归方程在病程早期对预测重症急性胰腺炎的预后及临床治疗有一定帮助 ;重症急性胰腺炎早期治疗中应强调维护全身脏器功能 ,积极纠正水电解质和酸碱平衡的紊乱 ,对降低死亡率具有重要的作用。

Objective To explore the relationship between risk factors and mortality of severe acute pancreatitis (SAP). Methods Clinical and laboratory data of 52 patients admitted to hospital within 24 hours were retrospectively analyzed. The relationship between the 27 possible risk factors and mortality was investigated using Logistic regression (performed with the help of computer software SPSS10.0), and the equation of Logistic regression was set up. Results Among the 27 possible risk factors pH, APACHⅡ scores, early shock, complicated with multiple system organ failure were associated with mortality. Bye one-way Logistic regression analysis of 27 parameters, shock, pleural effusion, pH, complications and APACHEⅡ scores were association with mortality, but by multi-way logistic regression ayalysis only pH was associated with mortality. Conclusions The equation is helpful for forecasting prognosis in early stage of SAP and guiding its treatment. It's important for reducing the mortality of SAP to maintain the normal function of the organ system and redress the waterelectrolyte and acid-base dysequilibrium actively.