论文部分内容阅读
目的:分析影响重症急性胰腺炎（severe acute pancreatitis, SAP）合并急性肾损伤（acute kidney injury, AKI）患者肾功能恢复的危险因素。方法:采用回顾性研究方法，收集2013年1月至2019年10月青岛大学附属医院ICU和EICU住院的105例SAP合并AKI患者的临床资料。根据28 d患者肾功能恢复情况，分为肾功能恢复组和恢复不良组，采用多因素logistic回归分析两组患者的临床资料，分析影响此类患者肾功能恢复的危险因素。结果:105例患者根据肾功能恢复情况分为恢复组（n n=73）和恢复不良组（n n=32），和肾功能恢复组相比，恢复不良组患者年龄更大，既往糖尿病及冠心病比例更高，APACHEⅡ评分更高，出现腹腔坏死物感染及腹腔出血的患者更多，且应用机械通气的比例更高。多因素logistic回归分析显示，腹腔坏死物感染（n OR=5.088，95%n CI：1.041~24.871，n P=0.044）和机械通气（n OR=4.615，95%n CI：1.126~18.904，n P=0.034）是影响SAP合并AKI患者肾功能恢复的独立危险因素。n 结论:腹腔坏死物感染、机械通气是SAP合并AKI患者肾功能恢复不良的独立危险因素。“,”Objective:To analyze the risk factors of renal function recovery in patients with severe acute pancreatitis (SAP) combined with acute kidney injury (AKI).Methods:A retrospective study was conducted in 105 SAP patients with AKI who were admitted to ICU or EICU of the Affiliated Hospital of Qingdao University from January 2013 to October 2019. According to the recovery of renal function at 28 days, the patients were divided into the renal function recovery group and the poor recovery group. Multivariate logistic regression analysis was used to analyze the clinical data of the two groups and to determine the risk factors related to renal function recovery.Results:According to the recovery of renal function, 105 patients were divided into the renal function recovery group (n n=73) and the poor recovery group (n n=32). Compared with the renal function recovery group, patients in the poor recovery group were older, had a higher prevalence of diabetes and coronary heart disease and a higher score on the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ); More patients had abdominal necrosis infection and abdominal hemorrhage. The proportion of patients who applied mechanical ventilation was higher in the poor recovery group. Multivariate logistic regression analysis showed that abdominal necrosis infection (n OR=5.088, 95%n CI:1.041-24.871, n P=0.044) and mechanical ventilation (n OR=4.615, 95%n CI:1.126-18.904, n P=0.034) were the independent risk factors of renal function recovery in SAP patients with AKI.n Conclusions:Abdominal necrosis infection and mechanical ventilation are the independent risk factors for renal function recovery in patients with SAP and AKI.