修订版亚特兰大分类在急性胰腺炎严重程度判断中的应用  

Application of revised Atlanta classification for the severity judgement in acute pancreatitis

作　　者：杨磊[1] 曹锋[1] 李非[1] 

机构地区：[1]首都医科大学宣武医院普通外科

出　　处：《临床外科杂志》2015年第8期591-593,共3页Journal of Clinical Surgery

摘　　要：目的验证修订版亚特兰大分类在急性胰腺炎（acute pancreatitis，AP）严重程度判断中的准确性。方法回顾分析2012年1月～2013年12月入院的243例AP患者的临床资料。依据修订版亚特兰大分类，分别计算轻型、中度重症、重症AP患者的全胃肠外营养时间（TPN）、ICU停留时间、住院时间、手术率及死亡率。结果243例资料完整的患者根据修订版亚特兰大分类，分别有49．4％（120／243）、46．9％（114／243）及3．7％（9／243）患者属于轻型、中度重症、重症AP。与轻型及中度重症AP相比，重症AP患者TPN使用时间[（1．4±1．1）d，（4．8±1．9）d，（11．1±9．2）d]、ICU停留时间[（1．1±0．6）d，（6．5±1．4）d，（14．0±8．8）d]、住院时间[（7．2±1．3）d，（21．1±8．7）d，（31．2±21．9）d]、手术率（0，21．1％，100．0％）及住院死亡率（0，1．8％，66．7％）显著升高。结论修订版亚特兰大分类能准确的反应AP患者的严重程度，区分各型AP患者预后。Objective To validate the accuracy of the revised Atlanta classification （RAC）for the severity judgement of acute pancreatitis （AP）. Methods The clinical data of 243 AP patients from January 2009 to December 2013 were reviewed retrospectively. According to RAC, the length of total parenteral nutrition,length of ICU and hospital stay, operation rate and mortality were assessed in mild, moderate and severe acute pancreatitis. Results Pancreatic or peripancreatic necrosis occurred in 65 patients （26.7%）. Fluid collection in and around the pancreas occurred in 114 patients. Transient and persistent organ failures occurred in 26 patients （ 10.7 % ）and 9 patients （3.7%）, respectively. On the basis of the RAC ,49.4% （ 120/243 ） ,46.9% （ 114/243 ） and 3.7% （9/243） patients bad mild, moderate and severe AP, respectively. The length of total parenteral nutrition,length of ICU and hospital stay, operation rate and mortality in severe AP patients elevated obviously. Conclusion The RAC can classify the severity of AP and differentiate prognosis in subgroups of AP patients accurately.

关 键 词：急性胰腺炎 亚特兰大分类 严重程度 

分 类 号：R576[医药卫生—消化系统]