摘要
目的探讨重症急性胰腺炎(SAP)患者并发急性呼吸窘迫综合征(ARDS)的影响因素。方法选取2012年3月—2018年4月江苏大学附属医院收治的SAP患者92例,记录其ARDS发生情况及严重程度,比较有无ARDS患者性别、年龄及入院时呼吸频率、中性粒细胞计数(PMN)、白细胞计数(WBC)、C反应蛋白(CRP)、血淀粉酶、尿淀粉酶、降钙素原(PCT)、血肌酐(Scr)、空腹血糖、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)、氧合指数、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、Ranson评分、感染情况;SAP患者并发ARDS的影响因素分析采用多因素Logistic回归分析。结果 (1)92例SAP患者中并发ARDS者41例(占44.6%),其中轻度17例、中度15例、重度9例。(2)有无ARDS患者性别、WBC、血淀粉酶、尿淀粉酶、PaO_2、PaCO_2、氧合指数比较,差异无统计学意义(P>0.05);有无ARDS患者年龄、呼吸频率、PMN、CRP、PCT、Scr、空腹血糖、APACHEⅡ评分、Ranson评分及合并感染情况比较,差异有统计学意义(P<0.05)。(3)多因素Logistic回归分析结果显示,年龄>50岁、呼吸频率>30次/min、PMN>14×10~9/L、CRP>150 mg/L、空腹血糖>12 mmol/L、APACHEⅡ评分>11分、Ranson评分>5分、合并感染是SAP患者并发ARDS的危险因素(P<0.05)。结论 SAP患者ARDS发生率较高,年龄>50岁、呼吸频率>30次/min、PMN>14×109/L、CRP>150 mg/L、空腹血糖>12 mmol/L、APACHEⅡ评分>11分、Ranson评分>5分、合并感染是SAP患者并发ARDS的危险因素,应针对上述危险因素进行有针对性的防治。
Objective To investigate the influencing factors of acute respiratory distress syndrome(ARDS)in patients with severe acute pancreatitis(SAP).Methods A total of 92 patients with SAP diagnosed and treated in the Affiliated Hospital of Jiangsu University were selected from March 2012 to April 2018,incidence and severity of ARDS were recorded.Gender,age,respiratory rate at admission,polymorphonuclear leukocytes(PMN)at admission,WBC at admission,CRP at admission,blood amylase at admission,urinary amylase at admission,PCT at admission,Scr at admission,FBG at admission,PaO2 at admission,PaCO2 at admission,oxygenation index(OI)at admission,APACHEⅡScore at admission,Ranson score at admission,and incidence of infections at admission were compared in SAP patients complicated with ARDS or not;multivariate Logistic regression analysis was used to analyze the influencing factors of ARDS in patients with SAP.Results (1)Of the 92 patients,41 cases(accounting for 44.6%)complicated with ARDS,there into 17 cases were mild,15 cases were moderate,9 cases were severe.(2)No statistically significant difference of gender,WBC,blood amylase,urinary amylase,PaO2,PaCO2 or OI was found in SAP patients complicated with ARDS or not(P>0.05),while there was statistically significant difference of age,respiratory rate on admission,PMN,CRP,PCT,Scr,FBG,APACHEⅡscore,Ranson score and incidence of infections in SAP patients complicated with ARDS or not(P<0.05).(3)Multivariate Logistic regression analysis results showed that,age over 50 years old,respiratory rate over 30 breaths per minute at admission,PMN over 14×109/L,CRP over 150 mg/L,FBG over 12 mmol/L,APACHEⅡscore over 11,Ranson score over 5 and infection were risk factors of ARDS in patients with SAP(P<0.05).Conclusion Risk of ARDS is relatively high in patients with SAP;age over 50 years old,respiratory rate over 30 breaths per minute at admission,PMN over 14×109/L,CRP over 150 mg/L,FBG over 12 mmol/L,APACHEⅡscore over 11,Ranson score over 5 and infection are risk factors of ARDS in pa
作者
胡振奎
张建国
张德厚
HU Zhenkui;ZHANG Jian-guo;ZHANG De-hou(Department of Critical Care Medicine,the Affiliated Hospital of Jiangsu University,Zhenjiang 212000,China)
出处
《实用心脑肺血管病杂志》
2018年第12期54-57,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
重症急性胰腺炎
呼吸窘迫综合征
成人
影响因素分析
Severe acute pancreatitis
Respiratory distress syndrome,adult
Root cause analysis
