摘要目的 探讨SAP后假性囊肿形成的早期危险因素.方法 采用前瞻性队列研究方法收集2005年7月至2007年3月收治的100例SAP患者,分析病因、入院24 h内临床和实验室检查、人院3 d内胸片、增强CT及超声检查等55个变量以及住院天数、病死率,并进一步行Logistic回归分析.结果 并发胰腺假性囊肿30例,发生率为30%.假性囊肿组的血清白蛋白浓度为(33.23±4.81)g/L、CT严重指数3～6分、住院天数为(26.83±19.76)d.均较无假性囊肿组的(36.07±4.92)s/L、2～4分、(14.51±7.71)d差异有统计学意义(P<0.05).而年龄、性别构成、入院时体温、呼吸频率、心率、平均动脉压、24 h尿量、24 h内通便与否、血常规、肝功能、肾功能、血电解质、血脂、PT、APTT、动脉血气、血淀粉酶、C反应蛋白、Ranson评分、APACHE Ⅱ评分、早期有无腹水及胸腔积液等指标两组之间差异均无统计学意义.Logistic回归分析显示,血清白蛋白浓度及CT严重指数是SAP后假性囊肿形成的独立危险因素.结论 SAP后假性囊肿形成的独立的危险因素是血清白蛋白浓度及CT严重指数.

abstractsObjective To investigate the early risk factors of the formation of pancreatic pseudocysts after severe acute pancreatitis. Methods One hundred patients with severe acute pancreatitis admitted from Jul. 2005 to Mar. 2007 were included. Clinical and laboratory data within 24 hours of admission and radiological tests of chest, abdominal dynamic contrast-enhanced computed tomography and abdominal ultrasound within 3 days after admission were analyzed and multiple stepwise logistic regression analysis was performed. Results 30 patients developed pancreatic pseudocysts and the incidence of pancreatic pseudocysts in the clinical course of severe acute pancreatitis was 30%. There were significant difference between group A (pancreatic pseudocyst group) and group B (non-pancreatic pseudocyst group) in serum albumin[(33.23±4.810g/L vs (36.07±4.92)g/L], CT severity index (CTSI) (3~6 vs 2~4 points) ,length of hospital stay[(26.83±19.760) day vs (14.51±7.71) days, (P<0.05)]. Meanwhile, there were no significant differences between the two groups in age, gender proportion, body temperature, heart rate, breath rate and mean arterial pressure in admission,urine volume within 24 hours, early defaecation within 24 hours after admission, blood routine, liver function, kidney function, electrolytes, blood cholesterol and triglycerol, PT, APTr, arterial blood gas analysis, blood amylase, C-reaction protein, APACHE Ⅱ, RANSON scoring, early ascites and pleural effusion. But multiple stepwise logistic regression analysis showed that the serum albumin and CTSI were associated with the formation of pancreatic pseudocysts after severe acute pancreatids. Conclusions The serum albumin and CTSI were the independent risk factors of the formation of pancreatic pseudocysts after severe acute pancreatitis.