DBC分类在急性胰腺炎严重程度判断中的应用  

Validation of the determinant-based classification for the severity of acute pancreatitis

作　　者：杨磊[1] 曹锋[1] 李昂[1] 李嘉[1] 方育[1] 王晓辉[1] 李非[1] 

机构地区：[1]首都医科大学宣武医院普通外科,北京100053

出　　处：《国际外科学杂志》2015年第6期373-375,共3页International Journal of Surgery

摘　　要：目的 验证DBC分类在急性胰腺炎严重程度判断中的准确性.方法 回顾性分析2012年1月-2013年12月入院的243例急性胰腺炎患者的临床资料.依据DBC分类,分别计算轻型、中型、重型及极重型急性胰腺炎患者的全胃肠外营养时间、ICU停留时间、住院时间、手术率及病死率.结果 243例资料完整的患者中,26.7％（65/243）的患者出现胰腺或胰周组织坏死,一过性及持续器官功能障碍发病率约为10.7％ （26/243）及3.7％（9/243）.根据DBC分类,分别有73.3％（178/243）、14.4％（35/243）、8.6％（21/243）及3.7％（9/243）患者属于轻型、中型、重型及极重型急性胰腺炎.与轻型及中型急性胰腺炎相比,重型及极重型急性胰腺炎患者全胃肠外营养应用率、营养时间、ICU停留时间、住院时间、手术率及住院病死率显著升高.结论 DBC分类能精确反应急性胰腺炎患者的严重程度.Objective To validate the accuracy of the determinant-based classification （DBC） for the severity of acute pancreatitis （AP）.Methods Retrospective analysis the clinical data of 243 patients with acute pancreatitis who admitted to our hospital between January 2012 and December 2013.Length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality was assessed,respectively in subgroup of mild,moderate,severe and critical acute pancreatitis according to DBC.Results Pancreatic or peripancreatic necrosis was present in 65 of the patients （26.7%）.Transient and persistent organ failures were present in 26 patients （10.7%） and 9 patients （3.7%）,respectively.On the basis of the DBC,178 （73.3%）,35 （14.4%）,21 （8.6%）,and 9 （3.7%） patients were determined to have mild,moderate,severe,or critical AP,respectively.The different categories of severity for DBC system were associated with statistically significant and clinically relevant differences in length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality.Conclusions The DBC accurately classify the severity of AP in subgroups of patients.

关 键 词：胰腺炎 DBC分类 疾病严重程度指数 回顾性研究 

分 类 号：R657.51[医药卫生—外科学]