外伤性胰腺炎的CT表现及预后评估  

CT features and prognosis evaluation of traumatic pancreatitis

作　　者：廖茜[1] 何文华[2] 余晨[1] 吕农华[2] LIAO Qian;HE Wenhua;YU Chen;Lü Nonghua(Department of Radiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China;Department of Gastroenterology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006 [2]南昌大学第一附属医院消化内科,江西南昌330006

出　　处：《实用放射学杂志》2021年第2期243-247,共5页Journal of Practical Radiology

摘　　要：目的研究外伤性胰腺炎的CT表现并评估其临床预后。方法回顾性分析经临床和手术证实为外伤性胰腺炎的55例患者临床资料及CT图像,并按损伤程度进行分级,分析不同严重度分级与临床预后的关系。结果55例外伤性胰腺炎中,Ⅰ级损伤15例(27%),Ⅱ级损伤13例(24%),Ⅲ级损伤20例(36%),Ⅳ级损伤3例(6%),Ⅴ级损伤4例(7%),各级损伤的治愈率分别为93%、77%、90%、100%、75%,病死率分别为7%、15%、0%、0%、25%。随访复查中,Ⅰ、Ⅱ、Ⅴ级损伤各有1例出现假性囊肿,Ⅲ级损伤有10例假性囊肿,Ⅱ、Ⅴ级损伤各有1例包裹性坏死,Ⅲ级损伤有2例包裹性坏死伴气体影;Ⅱ、Ⅲ级中出现胰瘘者分别为2例、3例,胰腺萎缩分别为1例、3例。结论CT能评估外伤性胰腺炎胰腺损伤程度及分级;通过CT随访可观察病变的演变过程。Objective To investigate the CT features and clinical prognosis in patients with traumatic pancreatitis.Methods The clinical data and CT images of 55 patients with traumatic pancreatitis confirmed by clinical and surgery were analyzed retrospectively.All of the cases were graded according to the degree of injury.The relationship between different severity grades and the clinical prognosis was analyzed.Results Among the 55 cases of traumatie pancreatitis,15 cases were grade Ⅰ injury(27%),13 cases were grade Ⅰ injury(24%),20 cases were grade Ⅲ injury(36%),3 cases were grade Ⅳ injury(6%),and 4 cases were grade Ⅴ injury(7%).The cure rates of each grade were 93%,77%,90%,100%and 75%,respectively。and the case fatality rates were 7%,15%,0%,0%and 25%,respectively.During the follow up,1 case pseudocyst was found in gradeⅠ, Ⅱ and Ⅴ injury respectively and 10 cases in grade Ⅲ injury.Wlled-off necrosis(WON)occurred in 1 case of grade Ⅱ and Ⅴ injury respectively.There were 2 cases of WON with gas shadow in grade Ⅰinjury.There were 2 cases and 3 cases of pancreatic fistula in grade Ⅱ and Ⅲ,and 1 and 3 cases of pancreatic atrophy,respectively.Conclusion CT can evaluate the degree of pancreatic injury of traumatic pancreatitis.The follow-up of CT can suggest the evolution of the lesions.

关 键 词：胰腺炎 计算机体层成像 预后 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]