急性胰腺炎胰周积液与临床严重程度及预后相关性  

Correlative Analysis between Peripancreatic Fluid Collection and Clinical Severity and the Prognosis of Acute Pancreatitis

作　　者：李道伟[1] 何丹[1] 董齐[2] 

机构地区：[1]辽宁省人民医院放射科,辽宁沈阳110016 [2]辽宁省人民医院普外科,辽宁沈阳110016

出　　处：《中国CT和MRI杂志》2012年第1期54-56,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨胰周积液与急性胰腺炎(AP)临床严重程度及预后的相关性。提高对急性胰周积液的认识。方法回顾分析证实的于2009年12月至2010年8月本院收治的76例急性胰腺炎(AP)患者CT表现及临床相关资料,记录CT严重程度指数(CTSI)评分、AP严重程度评分、胰周积液数目,并比较各指标间相关性。结果 76例AP患者中,轻症AP22例,重症AP54,重症AP中20例发生全身并发症。无急性胰周积液者17例,占22.4%,其中发展成重症胰腺炎者4例;仅1个部位一处发生急性胰周积液者35例,占46.1%,其中发展成重症胰腺炎者33例,急性胰周积液超过2个部位者24例,占31.6%,全部发展为重症胰腺炎。胰周积液数量与AP严重程度分级情况及CTSI评分均呈正相关(P<0.05)。以积液累及不同间隙数量判断重症AP的准确性,其准确度为92.10%,敏感度为93.44%,特异度为86.67%,阳性预测值为96.61%,阴性预测值为76.47%。结论急性AP胰周积液数量在一定程度反映急性胰腺炎的严重程度。急性胰周积液发生部位数量与重症胰腺炎发生率明显相关,判断急性重症胰腺炎的准确性较高,可作为一种临床上初步判断重症AP快速而简易的方法,并为临床治疗方案的合理制定起到指导性作用。Objective To explore the correlation between peripancreatic fluid collection and clinical severity and the prognosis of acute prognosis.To improve the recognition to acute pancreatitis.Methods CT manifestations and clinical data of 76 cases with acute pancreatitis which were confirmed between 2009-12 and 2010-08 were retrospectively reviewed.CTSI score,AP severity score and the number of peripancreatic fluid collection regions were recorded,and the correlation between these indexes was analyzed.Results 0f all the 76 cases,17 cases were mild acute pancreatitis and 54 cases were SAP（severe acute pancreatitis）.20 cases with SAP suffered with systemic complications.17 cases（22.4%） had no peripancreatic fluid collection,and 4 cases of them developed into SAP.Solitary peripancreatic fluid collection occurred to 35 cases（46.1%）,and 35 cases of them developed into SAP.24 cases（31.6%） had peripancreatic fluid collection more than 2 regions,and all of them developed into SAP.The number of peripancreatic fluid collection regions had positive correlation with AP severity and CTSI score（P0.05）.SAP was diagnosed by the number of peripancreatic fluid collection regions,and the accuracy,sensitivity,specificity,positive predictive value and negative predictive value was 92.1%,93.44%,86.67%,96.61% and 76.47%,respectively.Conclusion The number of acute peripancreatic fluid collection regions can reflect AP severity to a certain extent.Acute peripancreatic fluid collection has significant correlation with SAP.It has high accuracy to diagnose SAP,and it can be a fast and simple way to diagnose SAP preliminarily and guide the clinical treatment scheme.

关 键 词：胰腺炎 预后 胰周积液 

分 类 号：R814.42[医药卫生—影像医学与核医学] R576[医药卫生—放射医学]