螺旋CT对出血坏死性胰腺炎早期诊断及随访的评价

The evaluation of early diagnosis and follow-up on bleeding and necrotizing pancreatitis by spiral CT

目的评价螺旋CT对出血坏死性胰腺炎早期诊断及随访的临床价值。方法经螺旋CT检查诊断出血坏死性胰腺炎36例,均经临床及手术病理证实。结果36例中CT首诊提示正确诊疗34例,诊断符合率94%。早期CT表现为胰腺外形轮廓肿大、胰周脂肪层模糊或消失,胰腺实质内可见范围不等的低密度坏死灶,肾前筋膜增厚,胰周间隙渗出及积液,合并蜂窝组织炎等。随访中,4例死于多脏器功能衰竭,其余经手术和对症诊疗后有不同程度恢复。结论螺旋CT检查能及早发现出血坏死性胰腺炎的病理变化,并可作为随访该病病情转归的重要方法。

Objective To evaluate the value of early diagnosis and the follow-up of bleeding and necrotizing pancreatitis by spiral CT. Methods 36 cases with bleeding and necrotizing pancreatitis confirmed by clinical operation and pathology were examined by spiral CT. Results The accurate rate of diagnosis by spiral CT was 94%（34/36）.The CT findings mainly included pancreas swelling, peripancreatic fat faintness or vanish,necrosis of pancre without enhancement, vento--kidney tendon incrassation, peripancreatic space fluid collection, phlegrnon, etaL During the follow-up period, all cases recovered gradually after operations and treatment of symptoms excepting 4 cases who died caused by complications such as multiple organ dysfunction. Conclusion spiral CT can identify Bleeding and necrotizing pancreatitis early and also can regard as a significant follow-up method.