急性胰腺炎与胃肠道并发症相关性及原因分析

Reasons and correlations between gastrointestinal complications and acute pancreatitis

目的探讨急性胰腺炎的严重程度与胃肠道并发症发生机率的相关性及原因。方法收集93例急性胰腺炎病例,观察麻痹性肠梗阻、胃肠道水肿、肠系膜上动脉周围脂肪浸润及肠系膜上静脉血栓的螺旋CT表现。利用F isher确切算法对所有胃肠道并发症与重症胰腺炎之间的相关性进行分析。结果 CT发现胃肠道水肿37例、肠系膜上动脉周围脂肪浸润20例、麻痹性肠梗阻25例、肠系膜上静脉血栓1例,其对应的重症胰腺炎病例分别为35例、20例、24例、1例。这些胃肠道并发症与重症胰腺炎之间具有明显的相关性(P<0.05)。结论胰腺炎的胃肠道并发症强烈提示急性胰腺炎的严重性,增强螺旋CT有利于显示急性胰腺炎的胃肠道并发症,特别是肠道血管性病变。

Objective To explore the reasons and correlations between gastrointestinal complications and acute pancreatitis.MethodsThe spiral CT image of 93 patients with acute pancreatitis were observed in respect of paralytic ileus,gastrointestinal edema,adipose infiltration around superior mesenteric artery（SMA） and superior mesenteric vein（SMV） thrombosis.The correlations between gastrointestinal complications and severe acute pancreatitis（SAP） were analyzed using Fisher＇s exact test.Results Totally 37 cases of gastrointestinal edema,20 cases of adipose infiltration around SMA,25 cases of paralytic ileus and 1 case of SMV thrombosis were demonstrated in CT image corresponding to 35 cases,20 cases,24 cases and 1 case of SAP respectively.The correlation between gastrointestinal complications and SAP showed statistical significance（P0.05）.Conclusion The severity of gastrointestinal complications can imply the seriousness of SAP and the contrast-enhanced spiral CT is helpful in detecting gastrointestinal complications,especially gastrointestinal vascular diseases