摘要
目的探讨重症急性胰腺炎(SAP)后期发生包裹性坏死(WON)的危险因素。方法收集我院2016~2020年126例SAP患者临床资料,根据是否发生WON分为WON组和非WON组,比较两组患者的临床资料并分析观察时间≥28d的SAP患者并发WON的危险因素。从一般资料、病因、实验室检查、BMI、糖尿病、高血压、SIRS评分、MCTSI评分等参数中选取指标,采用单因素分析比较后,筛选出有统计学意义的因素纳入多因素Logistic回归分析。结果在126例SAP患者中,有37例(29.4%)患者发生WON。WON组男性、BMI≥25kg/m^(2)、D-二聚体≥5mg/L、WBC≥10×10^(9)/L、CT低增强病变、高脂血症性胰腺炎患者比例高于非WON组(P<0.05)。多因素Logistic回归显示BMI≥25kg/m^(2)[OR=5.735,95%CI(1.983,16.88),P=0.02]、D-二聚体≥5mg/L[OR=3.531,95%CI(1.201,10.44),P=0.021]和高脂血症性[OR=8.081,95%CI(1.570,41.71),P=0.014]是SAP后期并发WON的独立危险因素。结论高BMI、高D-二聚体及高脂血症性胰腺炎是SAP后期并发WON的危险因素。
Objective To investigate the risk factors of wallde-off necrosis(WON) in patients with severe acute pancreatitis(SAP). Methods A total of 126 cases of SAP in our hospital from 2016 to 2020 were collected. The clinical date of the two groups(WON group and non WON group) were compared and risk factors of WON in SAP patients with observation time over 28 days were analyzed. The indicators were selected from the general data, etiology, laboratory examination, BMI, diabetes, hypertension, SIRS score, MCTSI score and other parameters. The significant indicators in univariate analysis were selected and included in multivariate logistic regression analysis. Results Among 126 SAP patients, 37(29.4%) cases eventually developed into WON. The results of statistical analysis showed that the proportion of male, BMI≥25 kg/m^(2), D-Dimer≥5 mg/L, WBC≥10×10^(9)/L, hyperlipidemia and hypoenhanced pancreatic lesion in WON group were higher than those in non WON group(P<0.05). Multivariate logistic regression analysis showed that BMI≥25 kg/m^(2) [OR=5.735,95%CI(1.983, 16.88), P=0.02], D-Dimer≥5 mg/L [OR=3.531, 95%CI(1.201, 10.44), P=0.021], and hyperlipidemia [OR=8.081,95%CI(1.570, 41.71), P= 0.014] were the independent risk factors of WON in SAP. Conclusion High BMI, high D-Dimer and hyperlipidemia are the independment risk factors of WON in SAP.
作者
杜杰
张振海
张太哲
周硕
王振杰
Du Jie;Zhang Zhenhai;Zhang Taizhe(Department of Emergency Surgery,the First Affiliated Hospital ofBengbu Medical College,Bengbu 233004)
出处
《中国现代医药杂志》
2021年第9期8-12,共5页
Modern Medicine Journal of China
基金
蚌埠市科技创新指导类项目(编号:20200336)。
关键词
重症急性胰腺炎
包裹性坏死
危险因素
预后
Severe acute pancreatitis
Wallde-off necrosis
Risk factors
Prognosis
