Analysis Of Risk Factors For Severe Acute Pancreatitis Complicated With Portal Vein System Thrombosis

PurposeSevere acute pancreatitis(SAP)can be complicated by portal vein system thrombosis(PVST).By collecting and analyzing the complete case data of SAP in the First Affiliated Hospital of Hunan Normal University,we found the risk factors of SAP complicated with PVST,and provided reference for future clinical work.MethodsAccording to the inclusion criteria and exclusion criteria,clinical data of 195 SAP patients admitted to our hospital from December 2014 to December 2017 were collected,including general clinical data,laboratory examination,medical history,imaging examination and so on.The risk factors of SAP complicated with PVST were found by univariate analysis and multivariate unconditional logistic regression analysis of P< 0.05 variables.ResultCompared with non-thrombotic group,D-dimer results were4.82(+2.03)VS 3.09(+1.96),P < 0.001;C-reactive protein results were 239.83(+63.14)VS 177.37(+84.66),P = 0.001;pancreatic necrosis results were 79.2% VS 38.6%,P < 0.001;Male ratio results were 37.5% VS 61.4%,P = 0.026.With P < 0.05 as the initial screening condition,the sex,D-dimer,pancreatic necrosis or not,and C-reactive proteinwere analyzed by multivariate unconditional logistic regression,and the odds of pancreatic necrosis was obtained.Ratio(OR)= 4.094,95% CL: 1.368-12.253,P = 0.012,C-reactive protein(OR = 1.013,95% CL: 1.005-1.022,P = 0.002),D-dimer(OR = 1.460,95% CL: 1.156-1.843,P = 0.001)were significantly correlated with SAP complicated with PVST.Of the 24 thrombosis cases,9 cases were simple splenic vein thrombosis(37.5%)and 5 cases were simple portal vein thrombosis(20.8%).Simple superior mesenteric venous thrombosis occurred in 2 cases(8.3%).Among the 24 cases of thrombosis group,15 cases included splenic vein thrombosis,accounting for the highest proportion.Five of the 24 thrombotic patients died of SAP itself or complications during the follow-up period,and 20 of the 171non-thrombotic patients died of SAP itself or complications during the follow-up period.The mortality of thrombosis group was 20.8% in VS non-thrombosis group and 11.7% in VS non-thrombosis group.Conclusion1.Pancreatic necrosis,C-reactive protein and D-dimer are risk factors for PVST in SAP.2.Splenic venous thrombosis is the most common complication of SAP with PVST.3.The mortality of SAP patients with PVST is higher than that of SAP patients without PVST.