重症急性胰腺炎病程后期并发急性胆囊炎危险因素分析

摘要

目的:探讨重症急性胰腺炎(SAP)病程后期并发急性胆囊炎(AC)的危险因素.方法:采用病例对照研究的方法,回顾性收集确诊的20例SAP并发AC(SAP-AC)患者为病例组和86例SAP患者为对照组的各项资料,采用单因素和多因素非条件Logistic回归法筛选危险因素.结果:单因素Logistic回归分析显示Balthazar'CT评分、APACHE Ⅱ评分、全身并发症、局部并发症、生长抑索时间、EN持续时间、输血、手术等12个变量影响并发AC的发生；多因素Logistic回归分析显示APACHEⅡ评分(OR=1333)、肠道营养(EN)持续时间(OR=1.020)、胰头部坏死组织感染(0R=3.301)为并发AC的重要影响因素.结论:APACHEII评分越高、EN持续时间越长、胰头部坏死组织感染,其并发AC的风险性就越大,均为危险因素.%Objective: To explore the risk factors of later severe acute pancreatitis (SAP) complicated with acute cholecystitis (AC). Methods: With case-control study method, we retrospec-Tivly collected different data of 20 cases of SAP complicated with AC patients and 86 cases of SAP patients, and then used one factor non-conditional Logistic Regression method and muitiple factors Logistic Regression method to screen the risk factors of SAP-AC. Results: One factors Logistic Regression result showed that some factors which might influence SAP-AC, such as Balthazar'CT score, APACHE II score, complication, somatostatin time, EN lasting time, blood transfusion andOperation. And multiple factors Logistic Regression result indicated that APACHE II score (OR=1: 333), EN lasting time (OR=1.020) and necrotic tissue infection of pancreas he,ad (OR=3.301) af fected SAP-AC. Conclusions: We make clear that APACHE II score, EN lasting time and necrotic tissue infection of pancreas head were the main risk factors of SAP-AC.