| 摘要: |
| ［摘要］ 目的 探讨重症急性胰腺炎（SAP）患者发生急性期急性肺损伤(ALI)的相关危险因素。方法 选取114例SAP患者为研究对象,根据其发生急性期ALI的情况分成损伤组（n=36）和非损伤组（n=78）。回顾性分析两组患者的临床资料，对单因素分析后存在显著性差异的指标行非条件Logistic回归分析。结果 （1）两组患者性别、病因、平均住院天数、血糖浓度及慢性疾病史等一般资料比较差异无统计学意义（P>0.05）；损伤组年龄、病程、Ranson评分均显著高于非损伤组（P<0.01）；且损伤组器官受累≥2个、腹腔感染率、机械通气治疗率、合并全身炎症反应综合征（SIRS）率均显著高于非损伤组（P<0.01）；APACHEⅡ评分<8分率、吸烟史率则显著低于非损伤组（P<0.01）。（2）非条件Logistic回归方程显示年龄、病程、合并SIRS、器官受累情况、机械通气治疗、腹腔感染、Ranson评分等均为SAP患者发生急性期ALI的独立危险因素（P<0.05）；吸烟及APACHEⅡ<8分则为SAP患者发生急性期ALI的保护因素（P<0.05）。结论 年龄、病程、器官受累情况、机械通气治疗、腹腔感染、Ranson评分、合并SIRS等均为SAP患者发生急性期ALI的独立危险因素，需引起临床重视。 |
| 关键词: 重症急性胰腺炎 急性期 急性肺损伤 危险因素 |
| DOI：10.3969/j.issn.1674-3806.2016.10.17 |
| 分类号:R 563 |
| 基金项目: |
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| The risk factors of acute lung injury in acute stage in patients with severe acute pancreatitis |
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ZHANG Xiao-shan
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Intensive Care Unit, the First Affiliated Hospital of Nanyang Medical College, Henan 473000, China
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| Abstract: |
| ［Abstract］ Objective To investigate the related risk factors of acute lung injury(ALI) in acute stage in patients with severe acute pancreatitis(SAP).Methods One hundred and fourteen patients with SAP were selected as the research subjects. According to the incidence of ALI in the acute stage, the patients were divided into the injury group(n=36) and the non-injury group(n=78). The clinical data of the patients were retrospectively analyzed. The indexes with significant differences after univariate analysis were analyzed by non-conditional Logistic regression analysis.Results （1）There were no significant differences in general data such as gender, causes, average length of hospital stay, blood glucose concentration and chronic medical history between the two groups(P>0.05); The age, course of disease and Ranson score of the injury group were significantly higher than those of the non-injury group(P<0.01); Besides, the involved organs ≥2 and the rate of abdominal infection, the rate of mechanical ventilation therapy and the rate of complication with systemic inflammatory response syndrome(SIRS) in the injury group were significantly higher than those in the non-injury group(P<0.01); The rates of APACHEⅡ scores <8 points and smoking history in the injury group were significantly lower than those in the non-injury group(P<0.01).（2）Non conditional Logistic regression equation showed that age, course of disease, complication with SIRS, organs involved, mechanical ventilation therapy, abdominal infection and Ranson score were the independent risk factors for ALI in the acute stage in the patients with SAP(P<0.05), while smoking and APACHEⅡ<8 points were the protective factors(P<0.05).Conclusion Age, course of disease, organs involved, mechanical ventilation therapy, abdominal infection, Ranson score and complication with SIRS are the independent risk factors for ALI in the acute stage of the patients with SAP. |
| Key words: Severe acute pancreatitis Acute stage Acute lung injury Risk factors |
