重症急性胰腺炎新分型对病情评估的临床价值研究

Clinical value study on the new classification of severe acute pancreatitis to the condition assessment

目的 研究重症急性胰腺炎（SAP）新分型对病情评估的临床价值。方法 回顾性分析2008年6月-2013年6月124例确诊为SAP的患者的临床资料，其中符合中度重症急性胰腺炎（MSAP）诊断定义的有83例．符合SAP诊断定义的有41例。分析两组患者的急性胰腺炎严重程度床边指数（BISAP）评分，统计住院死亡率、总住院天数、ICU监护需要率、ICU监护天数、有创支持治疗需要率等方面的差异。结果 MSAP组和SAP组患者中，BISAP评分〈3分的患者分别为79例（95．2％）和3例（7．3％），BISAP评分≥3分的患者分别为4例（4．8％）和38例（92．7％），BISAP评分分别为（1．4±0．2）分和（3．2±0．7）分，差异有统计学意义（P〈0．01）；MSAP组和SAP组的住院死亡率（1．2%vs46．3％）、总住院天数（14．6±3．7vs30．4±6．3）、ICU监护需要率（18．1％vs80．5％）、ICU监护天数（3．0±0．8vs17．4±3．9）、有创支持治疗需要率（30．1％vs87．8％）差异有统计学意义（P〈0．01）。结论 SAP新分型有助于病情评估，并能早期准确识别危重症患者，减少不必要的医疗资源浪费，减轻患者的心理及经济负担。

Objective To investigate the clinical value of the new classification of severe acute pancreatitis （SAP） to the condition assessment.Methods 124 cases of patients diagnosed as SAP in our hospital from June 2008 to June 2013 were studied retrospectively.According to the new classification of SAP,83 cases were moderately severe acute pancreatit （MSAP）,41 cases were SAP.The severe acute pancreatitis bedside index （BISAP） score was analyzed,the in-hospital mortality,total hospital stay,need for ICU care,duration of ICU stay,need for invasive treatment were compared between two groups.Results In MSAP group and SAP group,BISAP score〈3 were 79 cases （95.2%） and 3 cases （7.3%） respectively,while BISAP score≥〉3 were 4 cases （4.8%） and 38 cases （92.7%） respectively,the BISAP score were 14.6±3.7 vs 30.4±6.3,there was significant difference between two groups （P〈0.01）.The MSAP group and SAP group of in-hospital mortality （1.2% vs 46.3%）,total hospital stay （14.6±3.7 vs 30.4±6.3）,need for ICU care （18.1% vs 80.5%）,duration of ICU stay （3.0±0.8 vs 17.4±3.9）,need for invasive treatment （30.1% vs 87.8%） had significant difference （P〈0.01）.Conclusion The new classification of SAP is helpful to the condition assessment,can early and accurately diagnose the critically ill patients,reduce the unnecessary waste of medical resources,reduce the psychological and economic burden of patients.