脾脏肿大在急性胰腺炎病情评估中的临床价值

The Clinical Value of Splenomegaly in Evaluation of Severity of Acute Pancreatitis

目的:研究脾脏肿大在急性胰腺炎病情评估中的临床价值。方法:收集33 例重症胰腺炎、36例轻症胰腺炎患者的病例资料,将两组的脾脏肿大情况进行比较分析;并对5例重症胰腺炎患者的脾脏厚度的变化情况加以分析。结果:重症胰腺炎组脾脏肿大占54.5%,而轻症胰腺炎组脾脏肿大仅为19.4%,两者相比有显著的统计学意义(P<0.01); 5例重症胰腺炎患者的超声结果分析发现,起病初期均有脾脏肿大。4例病情得到控制的患者,1例脾脏大小恢复正常,3 例不再继续增大;1例病情没有得到控制的患者,脾脏继续增大并最终死亡。结论:急性胰腺炎时,如出现下列情况应注意重症胰腺炎的可能性:①无其它原因可解释的脾脏肿大;②脾脏进行性增大者。

Objective: To evaluate the clinical value of splenomegaly in patients with acute pancreatitis.Methods:Clinical data from 33 patients with severe acute pancreatitis and 36 patients with mild acute pancreatitis were collected, and the occurence of splenomegaly were compared.In 5 patients with severe acute pancreatitis, the changes of spleen thickness were observed.Results:The occurence of splenomegaly was 54.5% in the severe acute pancreatitis group while 19.4% in the mild acute pancreatitis group;there was a significant difference between them (P< 0.01).According to the ultrasonic results,all spleens increase in size at the beginning of the disease among the five patients who had relatively detailed ultrasonic data.The spleen of the patient who died finally became further larger,while one restored to normal size and the other three stopped enlarging among the four patients whose severe pancreatitis were under control.Conclusions:The possibility of severe pancreatitis should be considered when the following events happen to patients with acute pancreatitis:①Splenomegaly without other reasons;②Progressive enlargement of the spleen.