急性胰腺炎并发全身炎症综合征的危险因素分析及临床干预

摘要

Objective To analysis the risk factors of acute pancreatitis(AP)complicated with systemic inflammatory response syndrome (SIRS),and explore the clinical interventions. Methods Retrospective analysis clinical data of 134 cases of patients with acute pancreatitis from February 2014 to March 2016,the correlation between the demographic data,biochemical indexes,acute physiology and chronic health status II (APACHE)score,body mass index(BMI)to SIRS were observed,the risk factors of AP and SIRS were analysised by single factor test and multivariate Logistic regression analysis. Results There were 61 cases of SIRS among 134 cases of AP patients,the incidence of AP complicated with SIRS was 45.52%. complication.Compared with the control group,patients in the case group have more SAP presents,higher body temperature, faster heart rate and respiratory rate,higher white blood cell count,higher blood lipid(TG),higher APACHE and BMI(P<0.05). Respiratory frequency,blood lipid level,APACHE and BMI were the independent risk factors for AP complicated with SIRS. Conclusion Faster respiratory frequency,higher blood lipid levelAPACHE and BMI were the independent risk factors for AP complicated with SIRS,clinical interventions should be targeted at these risk factors.%目的 分析急性胰腺炎(AP)并发全身炎症综合征(SIRS)的危险因素,探讨临床干预措施.方法 回顾性分析2014年2月至2016年3月134例急性胰腺炎患者的临床资料,观察人口统计学资料、生化指标、急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分、体质量指数(BMI)与SIRS的相关性,采用单因素检验和非条件多因素Logistic回归分析AP并SIRS的危险因素.结果 134例AP患者中,并发SIRS 61例,发生率为45.52%.AP患者并发SIRS与AP严重程度分型、体温、心率、呼吸频率、白细胞总数、血脂(TG)、APACHEⅡ、BMI等具有显著相关性(P<0.05).呼吸频率、血脂水平及APACHEⅡ、BMI是AP合并SIRS独立危险因素.结论 呼吸频率快、血脂水平高及APACHEⅡ评分高、BMI值高是AP合并SIRS的独立危险因素,临床应针对这些危险因素提前干预预防SIRS.