摘要
目的分析重症胰腺炎患者预后生存情况及与其临床特征的相关性。方法选取2014年2月-2017年5月我院收治的92例重症胰腺炎患者为研究对象,另选取同期轻度胰腺炎患者88例为轻度胰腺炎组和正常体检者80例为正常体检组,对3组临床资料进行回顾性分析,记录所有患者临床特征和重症胰腺炎患者预后情况,比较不同临床特征患者间预后生存的差异,分析两者之间的相关性。结果正常体检组和轻度胰腺炎组总胆红素、白细胞、血肌酐、血糖、血淀粉酶明显低于重症胰腺炎组,且正常体检组低于轻度胰腺炎组(P<0.05)。正常体检组和轻度胰腺炎组24 h尿量、血清白蛋白、血钙、动脉血氧分压显著高于重症胰腺炎组,且正常体检组高于轻度胰腺炎组(P<0.05);正常体检组尿淀粉酶、丙氨酸转氨酶显著低于轻度和重症胰腺炎组(P<0.05)。92例重症胰腺炎患者病死率为34.78%,将其按生存情况分为生存组60例,死亡组32例;死亡组患者血清白蛋白、血钙、动脉血氧分压明显低于生存组,年龄、血糖值显著高于生存组(P<0.01)。高龄、低动脉血氧分压、低血清白蛋白是造成重症胰腺炎患者死亡的早期危险因素(P<0.01,P<0.05)。结论高龄、低血清白蛋白、低动脉血氧分压是造成重症胰腺炎患者死亡的早期危险因素,对于老年患者应该密切观察其病情,提高氧分压,预防出现低氧血症,及时纠正低血清白蛋白,降低重症胰腺炎患者的病死率。
Objective To analyze the prognosis of patients with severe acute pancreatitis and its correlation with clinical features. Methods Ninety-two patients with severe acute pancreatitis treated in our hospital from February 2014 to May 2017 were selected as subjects. In addition, 88 patients with mild pancreatitis and 80 healthy people who underwent physical examinations in our hospital were enrolled as mild pancreatitis group and normal group respectively. The clinical data of all patients were retrospectively analyzed, and the clinical features of all patients and the prognosis of patients with severe pancreatitis were recorded. The differences in prognosis in patients with different clinical features were compared, and the correlation between the two indicators was analyzed. Results The total bilirubin, white blood cells, serum creatinine, blood glucose, and blood amylase in the normal and mild pancreatitis groups were significantly lower than those in the severe pancreatitis group, and the above indicators were lower in normal group than in mild pancreatitis group(P<0.05). In addition, 24-h urine volume, serum albumin, blood calcium, and arterial oxygen partial pressure(PaO2) were significantly higher in normal group and mild pancreatitis group than in severe acute pancreatitis group, and the indicators were higher in normal group than in mild pancreatitis group(P<0.05). Amylase in urine and alanine aminotransferase in the normal group were significantly lower than those in the mild and severe acute pancreatitis groups(P<0.05). The mortality of 92 patients with severe pancreatitis was 34.78%, and they were divided into survival group(n=60) and death group(n=32) according to their survival. The serum albumin, blood calcium, PaO2 in the death group were significantly lower than those in the survival group, while the age and blood glucose were significantly higher than those in the survival group(P<0.01). Advanced age, lower PaO2 and lower serum albumin was the early risk factor of death in patients with severe pancr
作者
赵彦
刘俐
吕辰艳
任田
ZHAO Yan;LIU Li;LYU Chen-yan;REN Tian(Department of Gastroenterology,the First Affiliated Hospital of Military Medical University of PLA Navy,Chongqing 400038,China)
出处
《解放军医药杂志》
CAS
2020年第5期78-81,98,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
重庆市科技计划项目(cstc2014yykfA110015)。
