發(fā)布時(shí)間：2018-06-05 08:52

  本文選題：重癥急性胰腺炎 + 持續(xù)性炎癥反應(yīng)-免疫抑制-分解代謝綜合征��； 參考：《醫(yī)學(xué)研究生學(xué)報(bào)》2017年07期

【摘要】：目的重癥急性胰腺炎(SAP)并發(fā)持續(xù)性炎癥反應(yīng)-免疫抑制-分解代謝綜合征(PICS)患者臨床特征及危險(xiǎn)因素研究較少。文中旨在總結(jié)SAP并發(fā)PICS患者的臨床特點(diǎn),對(duì)PICS發(fā)病的影響因素進(jìn)行多元回歸分析。方法回顧性分析2014年1月1日至2015年12月31日南京軍區(qū)南京總醫(yī)院普外科ICU住院時(shí)間14 d的214例SAP患者臨床資料。依據(jù)PICS診斷標(biāo)準(zhǔn)分成2組:PICS組(149例,SAP并發(fā)PICS患者)和非PICS組(65例,SAP患者未并發(fā)PICS)。比較2組患者全身系統(tǒng)性并發(fā)癥和胰腺炎特異性并發(fā)癥,ICU病死率及隨訪13個(gè)月的存活率;并對(duì)PICS發(fā)病的影響因素進(jìn)行多元回歸分析。結(jié)果 PICS組膽源性SAP、MODS發(fā)生率較非PICS組明顯升高(44.3%vs 29.2%、93.3%vs 55.4%,P0.05)。多元回歸分析顯示:BMI24(OR=2.307,95%CI:1.033~5.156)、膽源性病因(OR=4.207,95%CI:1.364~12.974)和多器官功能障礙綜合征(MODS)(OR=4.384,95%CI:1.334~14.405)是并發(fā)PICS的危險(xiǎn)因素。隨訪13個(gè)月的患者存活率PICS組較非PICS組明顯降低(88.5%vs 98.2%,P=0.036)。結(jié)論在臨床救治過(guò)程中,尤其需要警惕存在肥胖、膽源性病因以及MODS的SAP并發(fā)PICS患者。合并PICS可能是SAP患者預(yù)后不良的重要標(biāo)志。
[Abstract]:Objective to study the clinical characteristics and risk factors of severe acute pancreatitis (SAP) complicated with persistent inflammatory reaction-immunosuppressive catabolism syndrome (PICSs). The purpose of this article is to summarize the clinical features of SAP complicated with PICS and to analyze the influencing factors of PICS by multivariate regression analysis. Methods from January 1, 2014 to December 31, 2015, the clinical data of 214 patients with ICU in general surgery department of Nanjing military region General Hospital, Nanjing military region from January 1, 2014 to December 31, 2015, who were hospitalized for 14 days, were retrospectively analyzed. According to the diagnostic criteria of PICS, two groups were divided into two groups: PICS group (n = 149) and non PICS group (n = 65). The mortality and the survival rate of 13 months follow-up were compared between systemic and pancreatitis specific complications in two groups, and the influencing factors of PICS were analyzed by multivariate regression analysis. Results the incidence of biliary SAP mods in PICS group was significantly higher than that in non PICS group. The multiple regression analysis showed that the risk factors of PICS were: BMI24: 2.307 ~ 95CI: 1.033 / 5.156, OR 4.207 ~ 95 CI: 1.364 ~ 12.974) and MODS 4.384 ~ 95 CIW 1.33414.405). The survival rate of patients in the PICS group was significantly lower than that in the non-PICS group after 13 months follow-up. The survival rate was significantly lower in the PICS group than in the non-PICS group. Conclusion in the course of clinical treatment, it is necessary to be on guard against SAP complicated with PICS with obesity, choledochogenic etiology and MODS. PICS may be an important marker of poor prognosis in patients with SAP.
【作者單位】： 南京大學(xué)醫(yī)學(xué)院附屬金陵醫(yī)院(南京軍區(qū)南京總醫(yī)院)全軍普通外科研究所;
【基金】：國(guó)家自然科學(xué)基金(81570584) 江蘇省社會(huì)發(fā)展項(xiàng)目(BE2015685)
【分類號(hào)】：R576

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

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本文編號(hào)：1981408