急性胰腺炎脾大的CT与临床相关性分析

Correlation between CT Findings and Clinical Manifestations of Splenomegaly in Acute Pancreatitis

目的 分析急性胰腺炎脾肿大的CT表现及与其他CT征象、临床结果的相关性。资料与方法 回顾性研究 17例急性胰腺炎患者CT扫描脾容积的变化。全部病例均在发病初 (3d内 )行腹部CT检查 ,4～ 30d复查 1次 ,其中 5例为增强CT扫描。计算 2次CT扫描的脾容积及其增减百分率 ,并与其他CT征象及临床资料进行对照研究。结果 复查时脾容积 [(30 9.91± 2 0 9.5 8)cm3 ]与发病初脾容积 [(2 2 7.4 8± 14 4 .15 )cm3 ]相比增加 [(36±2 5 .9) % ](P <0 .0 2 )。其中脾容积增加显著 (≥ 5 0 % )的病例 ,CT严重度指数 (CTSI)评分较高 (P <0 .0 2 ) ,住院天数较长 (P <0 .0 1)。结论 脾大是急性胰腺炎的一个常见征象 ,常提示病情恶化、预后不良 ,对于临床及时采取适当治疗、提高治愈率及生存率有一定指导意义。

Objective To discuss the relationship between CT findings and clinical manifestations of splenomegaly in acute pancreatitis. Materials and Methods Splenic volume measurement and CT signs in 17 patients with acute pancreatitis were retrospectively studied. Abdominal CT scanning was performed in all 17 cases within 3 days after the onset of the disease. Follow-up CT exam was made in 4～30 days. Additional enhanced CT scanning was carried out in 5 cases. The splenic volume in each CT study was calculated.Results The follow-up splenic volume was 309.91±209.58cm 3, the volume was increased by 36± 25.9% when compared with its initial value (227.48±144.15cm 3), with P<0.02. Five patients, whose splenic volume was increased over 50%, had much higher CT severe index score (P<0.02) and longer hospitalization days (P<0.01).Conclusion Splenomegaly is a common finding in acute pancreatitis. Usually, it indicates the deterioration of the patient's condition and a bad prognosis. Proper treatment must be taken promptly when splenomegaly takes place.