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目的探析重症急性胰腺炎合并急性肾功能衰竭的临床特点及影响预后的相关因素。方法 650例重症急性胰腺炎患者,其中合并急性肾功能衰竭患者68例作为合并组,582例单纯重症急性胰腺炎患者作为未合并组,对合并急性肾功能衰竭发生及预后的相关因素进行分析。结果合并组患者年龄,腹腔大出血、感染、急性呼吸窘迫综合征(ARDS)、急性冠状动脉综合征(ACS)、多器官功能障碍综合征(MODS)发生率,急性生理学与慢性健康状况系统Ⅱ(APACHEⅡ)评分及全身炎症反应综合征(SIRS)持续时间(57.94±8.86)岁、25.00%、80.88%、73.53%、23.53%、76.47%、(14.61±3.14)分、(16.31±3.84)d与未合并组(40.11±8.57)岁、1.72%、24.05%、17.01%、3.44%、12.89%、(9.76±2.57)分、(5.88±3.28)d对比差异均具有统计学意义(P<0.05)。腹腔大出血、ARDS、ACS、MODS、APACHEⅡ评分是导致患者死亡的主要因素(P<0.05)。结论重症急性胰腺炎合并急性肾功能衰竭的预后受多方面因素影响,需给予早期引流治疗并加强重要脏器支持来降低死亡率。
Objective To investigate the clinical features of severe acute pancreatitis complicated with acute renal failure and the related factors that influence the prognosis. Methods Sixty - six patients with severe acute pancreatitis, 68 patients with acute renal failure complicated by acute renal failure, were enrolled in this study. 582 patients with severe acute pancreatitis as the non - combined group were enrolled in this study to analyze the related factors of the occurrence and prognosis of acute renal failure. Results Patients in the combined group had significant differences in age, major abdominal bleeding, infection, acute respiratory distress syndrome (ARDS), acute coronary syndrome (ACS), incidence of multiple organ dysfunction syndrome (MODS), acute physiology and chronic health system Ⅱ APACHEⅡscore and systemic inflammatory response syndrome SIRS duration (57.94 ± 8.86), 25.00%, 80.88%, 73.53%, 23.53%, 76.47%, (14.61 ± 3.14), (16.31 ± 3.84) d and The differences between the two groups were statistically significant (40.11 ± 8.57), 1.72%, 24.05%, 17.01%, 3.44%, 12.89%, (9.76 ± 2.57), 5.88 ± 3.28 (P <0.05) . Peritoneal hemorrhage, ARDS, ACS, MODS and APACHEⅡ scores were the main factors leading to death (P <0.05). Conclusions The prognosis of severe acute pancreatitis complicated with acute renal failure is affected by many factors. Early drainage treatment and strengthening the support of vital organs are needed to reduce the mortality.