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目的探讨与重症急性胰腺炎(SAP)早期胰腺感染有关的危险因素。方法回顾性分析2002年1月—2007年3月间收治的86例重症急性胰腺炎患者的年龄、性别、病因、入院时APACHEⅡ评分、血淀粉酶、血钙、血糖、血细胞比容、平均动脉压、ALT、AST、总胆红素、血清白蛋白、血肌酐、尿素氮、胰腺坏死、低氧血症、机械通气、肠功能障碍及导管应用等因素和胰腺感染的相关性。结果禁食时间、胰腺坏死程度、胆源性致病因素、低氧血症、肠功能障碍、血肌酐、尿素氮和入院血细胞比容与 SAP 患者继发感染的发生率呈正相关(P<0.05),血清白蛋白水平与 SAP 患者继发感染的发生率呈负相关(P<0.01);其余各影响因素与胰腺感染均无明显相关性(P>0.05)。结论在SAP 发病过程中,禁食时间较长、胰腺坏死程度增高、胆源性致病因素、低氧血症、肠功能障碍以及血肌酐、尿素氮和入院血细胞比容的升高可能是导致胰腺发生感染的重要因素。
Objective To investigate the risk factors associated with early pancreas infection in severe acute pancreatitis (SAP). Methods The clinical data of 86 patients with severe acute pancreatitis admitted from January 2002 to March 2007 were retrospectively analyzed in terms of age, gender, etiology, APACHEⅡscore, serum amylase, serum calcium, blood glucose, hematocrit, mean arterial pressure Pressure, ALT, AST, total bilirubin, serum albumin, serum creatinine, urea nitrogen, pancreatic necrosis, hypoxemia, mechanical ventilation, intestinal dysfunction and catheter application and other factors and pancreatic infection. Results Fasting time, pancreatic necrosis, biliary pathogenic factors, hypoxemia, intestinal dysfunction, serum creatinine, blood urea nitrogen and admission hematocrit were positively correlated with the incidence of secondary infection in patients with SAP (P <0.05 ), Serum albumin level was negatively correlated with the incidence of secondary infection in patients with SAP (P <0.01). There was no significant correlation between other factors and pancreatic infection (P> 0.05). Conclusion During the onset of SAP, the duration of fasting and pancreatic necrosis increased. The risk factors of biliary disease, hypoxemia, intestinal dysfunction and the increase of serum creatinine, urea nitrogen and admission hematocrit may be the leading factors An important factor in the pancreas infection.