APACHEⅡ,Ranson,Balthazar评估系统对重症急性胰腺炎诊断及预后评估的参考价值

Value of APACHEⅡ,Ranson and Balthazar scoring system predicting the severity and prognosis and indicating therapy for severe acute pancreatitis

目的分析APACHEⅡ、Ranson评分及Balthazar评分在预测重症急性胰腺炎(SAP)的病情严重度及治疗参考的应用价值。方法运用APACHEⅡ、Ranson及Balthazar评估系统对120例SAP患者的评分进行回顾性分析。结果APACHEⅡ评分在器官障碍组评分明显高于无器官障碍组(P<0.05),高分组器官障碍发生率高于低分组(P<0.05),死亡组评分高于存活组(P<0.05)。Ranson评分,有、无器官障碍及死亡组三者之间评分差异无统计学意义(P>0.05)。Balthazar分级及CTIS评分与临床预后密切相关,得分高的病死率显著上升(P<0.01)。结论APACHEⅡ、Ranson评分及Balthazar评分系统对判断病情及预后具有重要参考意义,Ranson价值有局限性,三种评分系统联合使用,对诊治及预后评估有指导意义。

Objective To investigate the applied value of APACHE Ⅱ , Ranson, Balthazar scoring system predicting the severity and prognosis and indicating clinical therapy for severe acute pancreatitis（SAP）. Methods All 120 cases of SAP evaluated by APACHE Ⅱ , Ranson and Balthazar scoring system were retrospectively analyzed. Results APACHE Ⅱ scores in organ dysfunction group were significantly higher than in the group without organ dysfunction（ P 〈 0.05）. The APACHE Ⅱ scores in death cases were higher than in survival cases（ P 〈 0.05 ）. The incidence of organ failure in higher score group was more than that in low score group（ P 〈0.05）. In Ranson scores,there was no significant difference between death group and survival group（ P 〉 0.05 ）. The CTIS scores of Balthazar sconng system were closely related to the prognosis. In the mortality in the higher score group was significantly higher than that in the lower score group （ P 〈 0.01 ）. Conclusion APACHE Ⅱ and Ranson combined with Balthazar scoring system could be used to evaluate the diagnosis, treatment and prognosis of SAP.