重症急性胰腺炎患者早期胰腺感染的危险因素分析

目的分析重症急性胰腺炎（severe acute pancreatitis，SAP）患者早期胰腺感染的危险因素，为SAP早期胰腺感染防治提供依据。方法选择2012年8月至2014年12月在我院收治的96例SAP患者的病历资料进行回顾性分析，其中合并胰腺感染45例作为观察组，未合并感染51例作为对照组。对两组患者的年龄、性别、就诊时间、APACHE II评分、血淀粉酶（Amylase，AMS）、血钙（Ca^2＋）、糖尿病史、低氧血症、机械通气进行单因素变量分析，并将具有统计学差异的单因素进行Logistic多因素分析。结果单因素分析显示，两组APACHE II评分、AMS、Ca^2＋、糖尿病史、低氧血症、机械通气的差异有统计学意义（t／Х^2=7．118，3．590，8．149，3．697，3．079，1．391；P〈0．05），即上述指标为SAP患者早期胰腺感染发生的危险因素；多因素回归分析显示，APACHEII评分、糖尿病史、低氧血症是SAP患者早期胰腺感染发生的独立危险因素。结论SAP患者早期胰腺感染的发生与APACHE II评分、糖尿病史、低氧血症等密切相关，医师应密切关注上述危险因素，进而避免或降低早期胰腺感染的发生。

重症急性胰腺炎早期胰腺感染的相关因素分析

目的探讨重症急性胰腺炎早期胰腺感染的相关因素,分析治疗方法。方法选取本院48例胰腺炎早期胰腺者,将患者分为感染组和肺感染组,对患者进行临床症状、辅助指标、其他因素的检查。结果两组患者在临床症状、APACHEⅡ评分、胃肠道障碍时间等数值上具有明显差异P<0.05,具有统计学意义,为该病的相关因素。结论重症急性胰腺炎患者治疗中存在危险因素,要对其高度警惕,降低感染率。

Infected pancreatic necrosis: Not necessarily a late event in acute pancreatitis

It is widely believed that infection of pancreatic necrosis is a late event in the natural course of acute pancreatitis. This paper discusses the available data on the timing of pancreatic infection. It appears that infected pancreatic necrosis occurs early in almost a quarter of patients. This has practical implications for the type, timing and duration of preventive strategies used in these patients. There are also implications for the classification of severity in patients with acute pancreatitis. Given that the main determinants of severity are both local and systemic complications and that they can occur both early and late in the course of acute pancreatitis, the classification of severity should be based on their presence or absence rather than on when they occur. To do otherwise, and in particular overlook early infected pancreatic necrosis, may lead to a misclassification error and fallacies of clinical studies in patients with acute pancreatitis.