摘要
目的研究重症急性胰腺炎(SAP)的临床表现特点并探讨入院24h内重症急性胰腺炎转归的危险因素。方法回顾性研究1995年1月至2006年7月我院收治的83例SAP,按预后分为死亡组13例和生存组70例,分别对两组患者入院24h内临床和实验室检查资料进行对比,进行多元方差分析和Logistic回归分析得出早期死亡相关因素及回归方程。结果多元方差分析示死亡组13例的APACHEⅡ评分、血浆凝血酶原时间、血清白蛋白水平,与生存组70例相比较,差异有统计学意义(P<0.05),而其他计量资料无显著差异。经多因素Logistic逐步回归分析显示,休克、MODS、腹水和SAP死亡相关。结论对SAP早期监测应重视APACHEⅡ评分、血浆凝血酶原时间、血清白蛋白的指标。休克、MODS、腹水和SAP死亡相关。利用Logistic回归分析建立的方程log(p/(1-p))=-72.15+18.316X1+35.834X2+36.316X3可供临床参考以预测生存或死亡的概率。
Objective To study the clinical characteristics of cases in severe acute pancreatitis （SAP） and investigate the risk factors of death in patients with severe acute pancreatitis within 24 hours after admission. Methods Clinical data of 83 SAP patients, who were admitted to our hospital from January 1995 to July 2006, were analyzed retrospectively. The patients were divided into death group（ 13 cases） and survival group（70 cases） according to their outcome. The clinical and laboratory data of all patients within 24 hours of admission were analyzed. Early risk factors associated with the death of severe acute pancreatitis and the equation of Logistic regression can be got using Logistic regression and Multivariate Analysis. Results APACHE Ⅱ score, coagulation function and serum albumin,were significantly different in death group compared with survival group（P 〈 0. 05）, but there was no difference in other measurement data using Multivariate Analysis. Multiple Logistic regression analysis showed that shock, multiple organ dysfunction syndrome （ MODS）, and ascites were associated with death of SAP patients. Conclusions APACHE Ⅱ score, prothrombin time and serum albumin should be addressed in the early observation of SAP. Shock, multiple organ dysfunction syndrome （MODS）, and ascites were associated with death of SAP patients. The equation of log（ p/（ 1 - p） ） = - 72. 15 ＋ 18. 316X1 ＋ 35. 834X2 ＋ 36. 316X3 made from Multiple Logistic regression analysis is helpful for forecasting prognosis in SAP.
出处
《肝胆外科杂志》
2009年第3期193-197,共5页
Journal of Hepatobiliary Surgery
