Should we perform decompressive laparotomy during severe acute pancreatitis with intra-abdominal hypertension below 25 mmHg:Only the gut knows

We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 mmHg.Indeed,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly restored.We report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

Acute pancreatitis as a rare complication of gastrointestinal endoscopy:A case report

BACKGROUND Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertriglyceridemia,hypercalcemia or the use of certain drugs.CASE SUMMARY A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy.The pain was predominantly in the upper and middle abdomen and was persistent and severe.The patient was diagnosed with acute pancreatitis.Treatment included complete fasting,octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion,ulinastatin injection to inhibit pancreatic enzymes activity,esomeprazole for gastric acid suppression,fluid replacement and nutritional support.Over the next 3 d,the patient's symptoms improved.The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.CONCLUSION Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.

Study on application of spiral CT perfusion technology in the diagnosis of acute pancreatitis

Objective:To explore the application value of spiral CT perfusion technology in the diagnosis of acute pancreatitis (AP).Methods:A total of 78 patients with AP who were admitted in our hospital from September, 2014 to September, 2016 were included in the study. The velocity method was used to detect S-Amy and U-Amy. The emulsion enhancement velocity scattering turbidimetry was used to detect CRP. ELISA was used to detect D-D. The patients in the control group were performed with abdomen CT, while AP patients were performed with 64 slice spiral CT. The most integrated layer of pancreas display was regarded as the perfusion weighted imaging scanning layer, and CT perfusion scanning was performed. BF, BV, MTT, and PS were calculated.Results: S-Amy, U-Amy, CRP, and D-D in AP patients were significantly higher than those in the control group. With the disease progression, S-Amy and U-Amy were significantly reduced, while CRP and D-D were significantly elevated. BF and BV in AP patients were significantly lower than those in the control group, and those in SAP patients were significantly lower than those in MAP patients. With the elevation of CT grading, BF and BV were significantly reduced, while the comparison of MTT and PS among the various grading was not statistically significant.Conclusions:The pancreas perfusion in AP patients is in a low perfusion state. BF and BV are negatively correlated with the severity degree of AP, which can predict the prognosis. BF and BV in combined with the serum S-Amy, U-Amy, CRP, and D-D can provide a forceful evidence for the diagnosis, treatment, and condition evaluation of AP.

Value of spiral CT perfusion parameters for evaluating acute pancreatitis and their correlation with inflammatory factor and JAK2/STAT3 signaling pathway

Objective: To study the value of spiral CT perfusion parameters for evaluating acute pancreatitis and their correlation with inflammatory factor and JAK2/STAT3 signaling pathway. Methods: Patients with acute pancreatitis and patients with pancreatic trauma who underwent surgical resection in Liaocheng Dongchangfu People's Hospital between May 2014 and March 2017 were selected and enrolled in the AP group and the control group of the research respectively;spiral CT perfusion scanning was conducted before surgery to measure the blood flow (BF), blood volume (BV), and mean transit time (MTT), and the serum was collected to determine the contents of inflammatory factors;pancreatitis tissue and normal pancreatic tissue were collected after surgical resection to determine the expression of JAK2/STAT3 signal molecules. Results: pancreatic tissue BF and BV levels of AP group were significantly lower than those of control group while MTT level was not different from that of control group;CRP, PCT, HMGB-1, Ghrelin and sTREM-1 contents in serum as well as JAK2, STAT3, Bcl-2 and Bcl-xL mRNA expression in pancreatic tissue of AP group were significantly higher than those of control group and negatively correlated with BF and BV levels in pancreatic tissue. Conclusion: Spiral CT perfusion parameters BF and BV can reflect the microcirculatory disorder of acute pancreatitis and are associated with the increased secretion of inflammatory factors and the activation of JAK2/STAT3 signaling pathway in the course of disease.

Prospective evaluation of the cause of acute pancreatitis,with special attention to medicines

AIM: To investigate the cause of acute pancreatitis(AP) by conducting a thorough investigation of drugs and their possible etiological role.METHODS: We investigated the cause of AP in a large retrospective cohort of 613 adult patients admitted with AP at the Akershus University Hospital, Norway, from 2000 until 2009, who were evaluated with standard ward investigations. This group was compared with a prospectively evaluated group(n = 57) admitted from January 2010 until September 2010 who investigated more extensively using medical history and radiological assessment.RESULTS: The groups were comparable with regards to gender, age, comorbidity and severity. The most common etiology was bile stones and alcohol, occurring in 60% in both groups. The prospective group was examined more thoroughly with regards to the use of alcohol and medicines. An increased number of radiological investigations during hospital stay and at follow-up were also performed. A more extensive use of radiological evaluation did not increase the detection frequency of bile stones. In the prospective group, more than half of the patients had two or more possible causes of pancreatitis, being mostly a combination of bile stones and drugs. No possible cause was found in only 3.5% of these patients, compared with 29.7% in the retrospective group.CONCLUSION: A detailed medical history and extensive radiological evaluation may determine a possible etiology in almost all cases of AP. Many patients have several possible risk factors, and uncertainty remains in establishing the definitive etiology.

Endoscopic ultrasonography and idiopathic acute pancreatitis

Idiopathic acute pancreatitis is a diagnostic challenge for gastroenterologists.The possibility of finding a cause for pancreatitis usually relies on how far the diagnostic study is taken.Endoscopic explorations such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography can help to determine the cause of pancreatitis.Furthermore,microscopic bile examination and magnetic resonance cholangiopancreatography can also be helpful in the work up of these patients.In this article an approximation to the diagnostic approach to patients with idiopathic acute pancreatitis is made,taking into account the reported evidence with which to choose between the different available explorations.

乌司他丁联合早期血液灌流治疗重症急性胰腺炎的临床疗效研究

目的探讨乌司他丁联合早期血液灌流对重症急性胰腺炎的治疗效果。方法60例重症急性胰腺炎患者,按随机数字表法将患者分为研究组和对照组,各30例。对照组应用乌司他丁治疗,研究组在对照组基础上开展早期血液灌流治疗。对比两组治疗效果及治疗前后血清炎性因子、症状评分、免疫功能指标、生活质量评分。结果研究组总有效率96.67%高于对照组的80.00%(P<0.05)。治疗后,两组C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)水平均较治疗前降低,且研究组CRP(5.89±1.06)mg/L、PCT(0.46±0.15)ng/ml、TNF-α(10.83±2.07)ng/L低于对照组的(7.02±1.27)mg/L、(0.69±0.23)ng/ml、(13.49±2.46)ng/L(P<0.05)。治疗后,两组腹痛、发热、恶心呕吐评分均比治疗前明显降低,且研究组腹痛评分(1.17±0.39)分、发热评分(1.06±0.31)分、恶心呕吐评分(1.16±0.40)分低于对照组的(1.58±0.43)、(1.52±0.48)、(1.61±0.45)分(P<0.05)。治疗后,两组CD3^(+)、CD4^(+)/CD8^(+)比治疗前均明显升高,且研究组CD3^(+)(41.92±2.43)%、CD4^(+)/CD8^(+)(1.89±0.34)高于对照组的(38.05±2.18)%、(1.52±0.31)(P<0.05)。治疗后,两组生理、心理、环境和社会关系评分比治疗前均明显升高,且研究组生理评分(89.75±6.48)分、心理评分(89.07±6.02)分、环境评分(90.14±6.15)分和社会关系评分(89.96±6.27)分均高于对照组的(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分(P<0.05)。结论对重症急性胰腺炎患者实施早期血液灌流与乌司他丁联合治疗可增强临床效果,改善患者症状、炎症反应,提升免疫功能及生活质量。

胰管支架置入对急性胆源性胰腺炎患者预后及并发症的影响

目的分析急性胆源性胰腺炎(ABP)患者应用胰管支架置入治疗对预后及并发症的影响。方法选取2019年1月至2022年12月收治的300例ABP患者,按治疗方法不同分组,A组100例行鼻胆管引流治疗,B组100例行开腹胆总管探查联合T型管引流术治疗,C组100例行鼻胆管引流联合胰管支架置入治疗,对比3组肝功能、并发症、死亡率及恢复情况。结果B组术后总胆红素(TBIL)、天冬酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平低于A组(P<0.05);C组术后TBIL、AST、ALT水平低于A组和B组(P<0.05);B组恢复进食时间、体温恢复时间、住院时间较A组更短(P<0.05);C组恢复进食时间、腹痛消失时间、体温恢复时间及住院时间短于A组和B组(P<0.05);C组并发症发生率4.00%低于A组的12.00%(P<0.05);C组1.00%死亡率低于A组8.00%(P<0.05)。结论ABP患者应用胰管支架置入治疗,可有缩短患者恢复时间,有利于改善肝功能,死亡率低,且并发症少。

不同时机行腹腔镜胆总管探查术治疗急性胆源性胰腺炎的临床效果

目的 探究不同时机行腹腔镜胆总管探查术(LCBDE)治疗急性胆源性胰腺炎(ABP)的临床效果。方法 回顾性选取2021年8月至2023年8月郑州大学第一附属医院医治的95例ABP患者临床资料,按照手术时机分为A组(49例)、B组(46例),前者于确诊后72 h内行LCBDE,后者于确诊后72~120 h内行LCBDE。比较两组手术指标、手术前后肝功能[碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)]、生化指标[二胺氧化酶(DAO)、血淀粉酶(AMS)、介导黏附反应的黏附分子(ICAM-1)]、免疫功能[免疫球蛋白G(IgG)、CD8^(+)、免疫球蛋白M(IgM)]、并发症。结果 两组出血量和中转开腹例数相比,差异无统计学意义(P>0.05);A组首次排气时间、首次排便时间、住院时间、手术时间、首次下床时间均短于B组(P<0.05);术后1周与B组相比,A组血清ALP、GGT、ALT水平较低(P<0.05);与术前相比,两组血清DAO、AMS、ICAM-1水平呈下降趋势(P<0.05);与术前相比,两组IgG、CD8^(+)、IgM指标呈上升趋势(P<0.05);两组并发症发生率相比,差异无统计学意义(P>0.05)。结论 ABP患者于确诊后72 h内行LCBDE能减少对免疫功能损伤,促进肝功能恢复,改善生化指标,缩短住院时间,促进患者快速恢复。

老年胆总管结石患者经内镜逆行胰胆管造影术插管取石后并发胆道感染、急性胰腺炎的相关因素分析

目的探讨老年胆总管结石患者内镜逆行胰胆管造影术(ERCP)插管取石后并发胆道感染、急性胰腺炎的相关因素。方法回顾性分析2021年7月至2022年12月于郑州大学附属郑州中心医院接受ERCP治疗的140例老年胆总管结石患者的临床资料,观察ERCP治疗效果及术后并发症发生的相关因素。结果140例接受ERCP的老年患者,138例成功插管,插管成功率为98.57%。129例患者一次性取石成功,一次取净率为93.47%。术后7例患者发生胆道感染,14例发生急性胰腺炎。经单因素、多因素logistic回归分析,高位胆道梗阻、合并糖尿病是老年胆总管结石患者ERCP术后并发胆道感染的独立危险因素(P<0.05);既往慢性胰腺炎史、导丝多次进入胰管、插管困难是老年胆总管结石患者ERCP术后并发急性胰腺炎的独立危险因素(P<0.05)。结论老年胆总管结石患者ERCP术后并发症影响因素主要为高位胆道梗阻、合并糖尿病、既往慢性胰腺炎史、导丝多次进入胰管、困难插管。

去脂血浆净化治疗急性高脂血症性胰腺炎的效果分析

目的:分析去脂血浆净化治疗急性高脂血症性胰腺炎的临床效果。方法:选取2020年1月—2022年9月东台市人民医院收治的急性高脂血症性胰腺炎患者85例,按照随机数字表法分为研究组和对照组,对照组(42例)使用血浆置换治疗,研究组(43例)则采用去脂血浆净化血液灌流治疗,比较两组临床疗效。结果:研究组治疗总有效率、高密度脂蛋白胆固醇(HDL-C)、转化生长因子-β(TGF-β)水平和平均动脉压(MAP)均高于对照组,三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、淀粉酶(AMS)、降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)水平均低于对照组,腹痛消失时间早于对照组,住院时间短于对照组,差异均有统计学意义(P<0.05)。结论:去脂血浆净化应用于血液灌流治疗急性高脂血症性胰腺炎效果显著,能够有效稳定患者血脂水平,同时改善其免疫功能。

Pancreatico-biliary endoscopic ultrasound:A systematic review of the levels of evidence,performance and outcomes

Our aim was to record pancreaticobiliary endoscopic ultrasound(EUS) literature of the past 3 decades and evaluate its role based on a critical appraisal of published studies according to levels of evidence(LE).Original research articles(randomized controlled trials,prospective and retrospective studies),meta-analyses,reviews and surveys pertinent to gastrointestinal EUS were included.All articles published until September 2011 were retrieved from PubMed and classified according to specific disease entities,anatomical subdivisions and therapeutic applications of EUS.The North of England evidencebased guidelines were used to determine LE.A total of 1089 pertinent articles were reviewed.Published research focused primarily on solid pancreatic neoplasms,followed by disorders of the extrahepatic biliary tree,pancreatic cystic lesions,therapeutic-interventional EUS,chronic and acute pancreatitis.A uniform observation in all six categories of articles was the predominance of LE Ⅲ studies followed by LE Ⅳ,Ⅱb,Ⅱa,Ⅰb and Ⅰ a,in descending order.EUS remains the most accurate method for detecting small(< 3 cm) pancreatic tumors,ampullary neoplasms and small(< 4 mm) bile duct stones,and the best test to define vascular invasion in pancreatic and peri-ampullary neoplasms.Detailed EUS imaging,along with biochemical and molecular cyst fluid analysis,improve the differentiation of pancreatic cysts and help predict their malignant potential.Early diagnosis of chronic pancreatitis appears feasible and reliable.Novel imaging techniques(contrast-enhanced EUS,elastography) seem promising for the evaluation of pancreatic cancer and autoimmune pancreatitis.Therapeutic applications currently involve pancreaticobiliary drainage and targeted fine needle injection-guided antitumor therapy.Despite the ongoing development of extra-corporeal imaging modalities,such as computed tomography,magnetic resonance imaging,and positron emission tomography,EUS still holds a leading role in the investigation of the pancreaticobiliary area.The major challenge of EUS evolution is its expanding therapeutic potential towards an effective and minimally invasive management of complex pancreaticobiliary disorders.

急性胰腺炎多层螺旋CT灌注成像的初步研究

目的:应用多层螺旋CT灌注扫描评价急性胰腺炎(AP)时的血流动力学改变。方法:65例病人行16排多层螺旋CT灌注扫描。应用Perfusion-3软件包进行数据分析,分别计算血流量(BF)、血容量(BV)、平均通过时间(MTT)和毛细血管表面通透性(PS)。结果:AP的BF、BV平均值较正常胰腺明显减少(P<0.05);MTT、PS略增加(P>0.05)。结论:AP血流灌注量明显减少,多层螺旋CT灌注成像可为胰腺炎的临床治疗提供一定的参考信息。

胰腺疾病CT灌注成像的研究进展

CT灌注作为一种反映组织血管的技术,可结合螺旋CT用于疾病诊断、判断预后以及进行治疗效果的评价。研究结果显示,CT灌注参数在正常胰腺组织及胰腺肿瘤、急性胰腺炎、胰岛细胞瘤中差异,具有显著性统计学意义,但这还处于初步研究阶段,正常和异常组的灌注参数均值和标准误都存在较大范围的交叉,而且不同研究报道的结果也有较大差异,仍需要探索新的更科学的CT灌注参数。这些参数必须充分考虑到不同患者的生理个性,如体质量、身高、年龄、心排血量等等。

急性胰腺炎的多层螺旋CT灌注成像研究

目的评价急性胰腺炎的多层螺旋CT(MSCT)灌注成像特点。方法应用16层螺旋CT对胰腺正常者44例,急性胰腺炎患者23例进行灌注扫描,使用AW4.1工作站perfusion3软件包进行图像处理,得到血流量(BF)、血容量(BV)、平均通过时间(MTT)和表面通透性(PS)等参数值。结果正常组BF、BV、MTT、PS值分别为:(174.77±75.62)ml/(100g·min)、(15.62±3.39)ml/100g、(7.45±2.82)s、(14.01±9.20)ml/(100g·min);急性胰腺炎组分别为:(101.50±49.50)ml/(100g·min)、(8.86±3.08)ml/100g、(8.31±3.06)s、(21.61±9.38)ml/(100g·min)。两组之间的BF、BV、PS值之间的差别有统计学意义(P<0.01),MTT值的差别没有统计学意义(P>0.05)。结论急性胰腺炎的血液灌注量减少,MSCT灌注成像对急性胰腺炎的诊断有一定的临床应用价值。

螺旋CT灌注技术在急性胰腺炎诊断中的应用研究

目的:探讨螺旋CT灌注技术在急性胰腺炎(AP)中的应用价值。方法:选取AP患者78例为研究对象,采用速率法检测血淀粉酶(S-Amy)、尿淀粉酶(U-Amy),乳胶增强速率散射比浊法检测C反应蛋白(CRP),ELISA法检测D-二聚体(D-D)。对照组于行腹部CT检查时,A P患者于入院48h内采用64排螺旋CT进行腹部CT平扫,选定胰腺显示最为完整的层面作为灌注成像扫描层面行CT灌注扫描,计算血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)。结果:AP患者S-Amy、U-Amy、CRP、D-D明显高于对照组,随病情加重S-Amy、U-Amy有所下降,CRP、D-D逐渐升高;AP患者BF、BV值明显低于对照组,SAP患者低于MAP患者,且随着CT分级的升高,BF、BV值逐渐降低,而MTT、PS值各分级间无明显差异。结论:AP患者胰腺灌注呈低灌注状态,BF、BV与AP严重程度呈负相关,并可提示患者预后状况,联合血清S-Amy、U-Amy、CRP、D-D等生化指标检测,为AP的诊治及病情评估提供有力依据。

CT灌注成像对急性胰腺炎患者肾脏血流动力学的研究

目的应用多层螺旋CT(MSCT)灌注成像技术测量和评价急性胰腺炎患者的肾脏血流灌注情况,探讨急性胰腺炎肾脏血流变化的特点。方法对24例正常对照组和59例急性胰腺炎病例组,其中轻症胰腺炎21例,重症胰腺炎38例,行64排128层螺旋CT肾脏灌注检查。在工作站上使用perfusion 4软件包对数据进行处理,得出感兴趣区的灌注参数值,包括血流量(blood flow,BF),血容量(blow volume,BV),对比剂平均通过时间(mean transit time,MTT)和表面渗透积乘积(permeability surface area product,PS)。采用SPSS13.0软件包进行统计分析。结果 MAP、SAP较正常对照组肾皮质BF值明显减低,MTT值明显延长[肾皮质BF对照组(345.74±106.69)ml·100g-1·min-1,MAP组(261.56±49.96)ml·100g-1·min-1,SAP组(229.28±29.51)ml·100g-1·min-1;P<0.05。MTT:对照组(7.89±4.69)s,MAP组(10.19±1.99)s,SAP组(12.67±4.23)s,P<0.05],SAP较正常对照组肾皮质PS值明显减低[对照组(69.08±38.87)ml·100g-1·min-1,SAP组(52.82±25.59)ml·100g-1·min-1;P<0.05];3组间的肾髓质参数及肾皮质BV值差别无统计学意义(P>0.05)。结论急性胰腺炎导致肾脏皮质BF值明显减少,MTT明显延长,肾髓质各参数及肾皮质BV值无明显变化。

犬自身胆汁灌注胰管与急性胰腺炎病变程度的关系

为探讨自身胆汁灌注胰管与急性胰腺炎时胰腺病理改变的关系，采用３０只本地健康成年杂种犬，随机分为５组，每组各６只，以不同压力、不同持续时间灌注犬胰管，观察胰腺的组织学变化。结果发现：胆汁灌注的压力越高，持续时间越长，越容易引起急性出血坏死性胰腺炎，而且坏死病变越重；相反，则主要引起急性水肿性胰腺炎。从而证明胆汁灌注的压力、持续时间及二因素的协同作用对急性胰腺炎严重程度有显著影响，早期减压可能有助于改善急性胰腺炎的预后。

急性梗阻性胰腺炎大鼠胰腺腺泡细胞凋亡的变化

目的:结合胆管压力的变化来探讨胰腺炎轻重程度与胆胰管梗阻时间及腺泡细胞凋亡的关系．方法:采用结扎胆胰管的方法制成胰腺炎模型．分别于梗阻后4、8、12 h以及解除梗阻后1、3 d分别测定胆管压力．流式细胞分析法检测胰腺腺泡细胞Annexin V-FITC／PI和 Caspase-3的表达．结果:与正常对照组(16．42±1．03)相比,随着梗阻时间的延长,胆管压力明显增高(4,8, 12 h分别为49．98±3．05,90．20±8．66,589．00 ±60．10),而在解除梗阻后,压力迅速下降并在1 d即恢复正常(1,3 d分别为17．50±2．84, 16．37±0．46),变化显著(P<0．01)．AnnexinV- FITC／PI检测显示梗阻4 h时细胞凋亡较多, 至梗阻12 h时,腺泡细胞凋亡明显减少而坏死增加;在解除梗阻后,随着时间的延长凋亡明显增多,坏死逐渐减少,变化显著(P<0．01)． Caspase-3检测显示在梗阻4 h时凋亡表达最高,梗阻8 h已明显减少,12 h则以坏死为主要表达方式;解除梗阻后1 d仍以坏死为主,到第3天则表现出大量的凋亡,变化显著 (P<0．01)．结论:胆管压力升高引起的胆胰液返流是胰腺炎的发病机制之一,并可引起胰腺腺泡细胞的凋亡减少,而早期恢复正常胆胰管压力可使细胞凋亡增多,有效的阻止急性胰腺炎的病情发展．

急性胰腺炎超低剂量CT灌注重建的多期图像质量评估

目的基于第三代双源CT上腹部超低剂量灌注成像,重建动脉期、门脉期图像,对比研究急性胰腺炎患者重建图像与常规CT增强扫描的图像质量。方法纳入拟诊为急性胰腺炎的患者33例行超低剂量CT灌注扫描,收集同期行上腹部常规增强扫描的患者35例作为对照组。对上述各期图像质量进行客观及主观评价,并记录辐射剂量。客观测量指标包括各期腹主动脉CT值、门静脉CT值及胰腺CT值,并以腰大肌为参照物计算出各期腹主动脉、门静脉及胰腺的信噪比(SNR)、对比噪声比(CNR),并比较其差异。结果腹主动脉CT值、CNR、SNR及胰腺CT值、CNR灌注重建动脉期、门脉期均高于常规增强扫描,门静脉CT值、CNR、SNR及胰腺SNR灌注重建门脉期高于常规增强扫描,差异均有统计学意义(P<0.05);胰腺SNR灌注重建动脉期与常规增强扫描无统计学差异(P>0.05);门静脉CT值、CNR、SNR灌注重建动脉期低于常规增强扫描,差异有统计学意义(P<0.05)。灌注重建动脉期、门脉期图像质量主观评分为(4.6±0.48)、(4.6±0.49)分,主观评分一致性较好(Kappa=0.667、0.678)。上腹部超低剂量灌注扫描辐射剂量为(8.4±0.7)mSv。结论在急性胰腺炎患者中,基于第三代双源CT超低剂量灌注重建的多期图像质量不低于常规CT增强扫描图像,可用于临床诊断工作。