腹部CT平扫在急性胰腺炎诊断和预后预测中的应用

Application of Abdominal CT Scan in Diagnosis and Prognosis Prediction of Acute Pancreatitis

研究腹部CT平扫在急性胰腺炎诊断中的应用及对预后预测的价值。回顾性分析164例急性胰腺炎患者临床资料,分析急性胰腺炎腹部CT影像学特征;根据并发症及死亡作为判断预后标准。采用Logistic回归分析法明确影响急性胰腺炎患者发生并发症及死亡的危险因素。采用Bahhazar-CTSI评分系统对患者病情进行分级,比较不同CTSI评分患者的并发症发生率及死亡率情况;观察急性胰腺炎患者病情严重程度与并发症及死亡的关系。在164例急性胰腺炎患者并发症发生率为51.83%,死亡率为7.32%。急性胰腺炎患者发生并发症及死亡与脂肪肝、胃裸区受侵、肾上腺受侵、肝上间隙积液以及肾周围间隙受侵有关(P<0.05)。重度脂肪肝、胃裸区受侵、肾上腺受侵、肝上间隙积液以及肾周围间隙受侵均是影响急性胰腺炎患者发生并发症的危险因素(P<0.05),胃裸区受侵、肾上腺受侵、肝上间隙积液均是影响急性胰腺炎患者发生死亡的危险因素(P<0.05)。Bahhazar-CTSI评分与急性胰腺炎患者并发症发生率、死亡率呈正相关(r=0.657、0.688,P<0.05)。急性胰腺炎腹部CT影像学具有征象特征性,可明确显示胰腺病变程度及周围组织器官累及情况,对急性胰腺炎的诊断与预后有较高的预测价值。

This paper investigated the application of abdominal CT scan in the diagnosis and prognosis prediction of acute pancreatitis. The clinical data of 164 patients with acute pancreatitis were retrospectively analyzed. The abdominal CT imaging features of acute pancreatitis were analyzed and the complications and death were used as the prognostic criteria. Logistic regression analysis was used to identify the risk factors of complications and death in patients with acute pancreatitis. Bahhazar-CTSI scoring system was used to grade the patients’ condition, and the incidence of complications and mortality of patients with different CTSI scores were compared. The relationship between severity of acute pancreatitis and complications and death were analyzed. In 164 cases of acute pancreatitis patients, the incidence rate was 51.83%, the mortality rate was 7.32%. The complications and death of patients with acute pancreatitis were related to fatty liver, invasion of bare area of stomach, invasion of adrenal gland, effusion of suprahepatic space and invasion of perirenal space(P<0.05).The severe fatty liver,gastric bare area invasion,adrenal gland invasion,suprahepatic space effusion and perirenal space invasion were risk factors for complications in patients with acute pancreatitis(P<0.05),and gastric bare area invasion,adrenal gland invasion and suprahepatic space effusion were risk factors for death in patients with acute pancreatitis (P<0.05).Bahhazar-CTSI score was positively correlated with the incidence of complications and mortality in patients with acute pancreatitis(r=0.657,0.688,P<0.05).Abdominal CT imaging of acute pancreatitis has characteristic signs,which can clearly show the degree of pancreatic lesions and the involvement of surrounding tissues and organs,which has high predictive value for the diagnosis and prognosis of acute pancreatitis.