采用CT影像学征象评估急性重症胰腺炎病情分级的可靠性研究

Reliability of CT Imaging Signs to Evaluate the Grade of Acute Severe Pancreatitis

目的分析CT影像学征象评估急性重症胰腺炎病情分级的可靠性。方法选取本院2017年3月至2019年4月收治的89例急性重症胰腺炎患者的临床资料。根据病情情况分为轻度组49例,重度组40例,均进行CT检查。对患者所得图像进行分析,比较不同病情程度急性重症胰腺炎患者影像学表现、并发症情况以及CT分级与患者预后关系。结果轻度急性重症胰腺炎患者CT检查中出现胰腺体积增大、脂肪层模糊不清、单区域胰腺液潴留、多区域胰腺液潴留、气泡症、片状坏死情况均明显低于重度组(P<0.05);轻度组局部急性液体积囊、假性囊肿、胰腺坏死、胰腺囊肿、出血情况均低于重度组患者(P<0.05);根据CT分级分为轻中度组57例,重度组32例,轻中度组住院天数明显低于重度组,无死亡情况出现,重度组死亡率为12.50%(P<0.05)。结论CT检查显示出急性重症胰腺炎患者病灶基本情况,通过影像学表现评估患者病情严重程度,有利于临床根据患者病情分级进行针对性治疗,可从临床评估患者预后中获益。

Objective To analyze the reliability of CT imaging signs to evaluate the grade of acute severe pancreatitis.Methods The clinical data of 89 patients with acute severe pancreatitis admitted in our hospital from March 2017 to April 2019 were selected.According to their condition,they were divided into 49 cases in the mild group and 40 cases in the severe group,all underwent CT examination.The images of the patients were analyzed to compare the imaging manifestations,complications and the relationship between CT grading and prognosis of patients with acute severe pancreatitis in different degrees of severity.Results In CT examination of patients with mild acute severe pancreatitis,the incidences of increasing of pancreas volume,unclear fat layer,pancreatic fluid retention of singleregion,pancreatic fluid retention of multi-region,gas-bubble disease and flaky necrosis were both significantly lower than those in severe group(P<0.05).The accumulation of local acute fluid in the sac,pseudocysts,pancreatic necrosis,pancreatic cysts,and bleeding in the mild group were lower than those in the severe group(P<0.05).According to CT classification,the patients were divided into 56 cases in the mild to moderate group and 32 cases in the severe group.The number of hospital stays in the mild to moderate group was significantly lower than that in the severe group,and no death occurred.The mortality rate in the severe group was 12.50%(P<0.05).Conclusion CT examination shows the basic condition of the lesions of patients with acute severe pancreatitis.Evaluating the severity of the patient's condition through imaging performance is conducive to targeted treatment according to the patient's condition and can benefit the clinical evaluation of the patient's prognosis.