中西医结合治疗重症急性胰腺炎CT影像变化研究

CT Imaging Changes of Integrated Traditional Chinese and Western Medicine in Treatment of Patients with Severe Acute Panreatitis

目的探讨中西医结合治疗重症急性胰腺炎(severe acute pancreatitis,SAP)的临床指标及CT影像学变化。方法选取2013年1月—2015年1月我院65例SAP给予常规治疗、生长抑素和清胰承气汤治疗,10 d为1个疗程。治疗前后行CT检查和炎性因子检测,并观察疗效。结果治疗总有效率96.92%。与治疗前相比,治疗后白介素-6、肿瘤坏死因子-α均显著下降,白介素-10显著上升(P<0.01);胰头、胰体、胰尾CT检查胰腺密度显著升高(P<0.01)。治疗后CT平扫显示,胰腺体积减小,出血、坏死病灶部分或完全吸收,积液消失,肾前筋膜变薄。结论中西联合治疗SAP疗效确切,CT可用于定量技术评估SAP治疗效果。

Objective To investigate clinical indexes and CT imaging changes of integrated traditional Chinese and western medicine in treatment of patients with January severe acute pancreatitis（ SAP）. Methods A total of 65 SAP patients admitted during January 2013 and January 2015 were treated with conventional therapy,Somatostatin and Qingyichengqi decoction,and one course of treatment was 10 d. CT examination and detection of inflammatory factors were performed before and after treatment,and curative effect was also observed. Results The total efficacy rate was96. 92%. Compared with those before treatment,levels of interleukin-6（ IL-6） and tumor necrosis factor-α（ TNF-α）significantly decreased,while interleukin-10（ IL-10） significantly increased after treatment（ P〈0. 01）; density values of head,body and tail of pancreas through CT examination significantly increased after treatment（ P〈0. 01）. After treatment,CT scan showed that pancreatic volume decreased,hemorrhage and necrosis focuses were partially or completely absorbed,effusion disappeared,and anterior renal fascia attenuated. Conclusion CT can be applied in quantification technique in evaluation of the curative effect in SAP.