重庆医学2024,Vol.53Issue(8) :1173-1178.DOI:10.3969/j.issn.1671-8348.2024.08.010

重症急性胰腺炎并发内脏静脉血栓的危险因素分析

Analysis on risk factors of severe acute pancreatitis complicating splanchnic venous thrombosis

唐琪 罗娜 张秉强
重庆医学2024,Vol.53Issue(8) :1173-1178.DOI:10.3969/j.issn.1671-8348.2024.08.010

重症急性胰腺炎并发内脏静脉血栓的危险因素分析

Analysis on risk factors of severe acute pancreatitis complicating splanchnic venous thrombosis

唐琪 1罗娜 2张秉强1
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作者信息

  • 1. 重庆医科大学附属第一医院消化内科,重庆 400016
  • 2. 重庆医科大学附属第一医院重症医学科,重庆 400016
  • 折叠

摘要

目的 探讨重症急性胰腺炎(SAP)并发内脏静脉血栓(SVT)的危险因素,以指导临床进行早期预防.方法 选取2018年1月至2022年12月该院收治的173例SAP患者,根据住院期间是否并发SVT分为未并发SVT组(n=143)、并发SVT组(n=30).收集患者一般资料及各类临床治疗检查相关资料,多因素logistic回归分析SAP并发SVT的危险因素.结果 两组休克(P<0.001)、胰腺囊肿(P=0.002)、气管插管(P<0.001)、肾功能异常(P=0.014)比例,以及总胆红素(P=0.049)、直接胆红素(P=0.018)、AST(P=0.011)、降钙素原(P=0.021)、凝血酶时间(P=0.024)、D-二聚体(P=0.003)、MCTSI评分(P<0.001)、A-PACHEⅡ评分(P<0.001)比较差异有统计学意义.多因素logistic回归分析显示,有胰腺囊肿(OR=2.700,95%CI:1.022~7.134,P=0.045)、APACHE Ⅱ评分升高(OR=1.137,95%CI:1.002~1.290,P=0.047)是SAP并发SVT的独立危险因素.结论 有胰腺囊肿、APACHE Ⅱ评分升高是SAP并发SVT的独立危险因素,需要对患者密切随访并及时干预治疗.

Abstract

Objective To investigate the risk factors of complicating splanchnic venous thrombosis (SVT) in severe acute pancreatitis (SAP) in order to guide clinic for conducting early prevention.Methods A total of 173 patients with SAP admitted and treated in this hospital from January 2018 to December 2022 were selected and divided into the non-complicating SVT group (n=143) and complicating SVT group (n=30) ac-cording to whether having secondary SVT or not.The general data and various clinical treatment and examina-tion-related data were collected.The multi-factor logistic regression was used to analyze the risk factors of complicating SVT in SAP.Results Shock (P<0.001),pancreatic cyst (P=0.002),tracheal intubation (P<0.001),proportion of abnormal renal function (P=0.014),total bilirubin (P=0.049),direct bilirubin (P=0.018),AST (P=0.011),procalcitonin (P=0.021),thrombin time (P=0.024),D-dimer (P=0.003),MCTSI score (P<0.001) and APACHE Ⅱ score (P<0.001) had statistical difference between the two groups.The multivariate logistic regression analysis showed that pancreatic cyst (OR=2.700,95%CI:1.022-7.134,P=0.045) and APACHE Ⅱ score increase (OR=1.137,95%CI:1.002-1.290,P=0.047) were the independent risk factors for complicating SVT in SAP.Conclusion Pancreatic cysts and APACHE Ⅱ score increase are the independent risk factors for complicating SVT in SAP.These patients require close fol-low-up and timely intervention and treatment.

关键词

重症急性胰腺炎/胰腺囊肿/内脏静脉血栓/危险因素/APACHE/Ⅱ评分

Key words

severe acute pancreatitis/pancreatic cyst/splanchnic vein thrombosis/risk factors/APACHE Ⅱ score

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基金项目

重庆市科卫联合医学科研项目(2021MSXM044)

出版年

2024
重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
参考文献量27
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