目的探讨胃肠道功能与急性胰腺炎病情严重程度的关系。方法回顾性总结我科2001年9月-2012年8月成功救治的42例急性胰腺炎患者的临床资料。将患者胃肠道功能按严重程度进行评分,同时评测患者入院当天的急性生理及慢性健康状况评分Ⅱ(acut...目的探讨胃肠道功能与急性胰腺炎病情严重程度的关系。方法回顾性总结我科2001年9月-2012年8月成功救治的42例急性胰腺炎患者的临床资料。将患者胃肠道功能按严重程度进行评分,同时评测患者入院当天的急性生理及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)和CT严重度指数(computer tomography severityindex,CTSI)评分,将胃肠道功能中重度不良天数与ICU住院天数、呼吸机使用天数进行相关性分析。比较胃肠道中重度不良组与轻度不良组中重症患者比例。结果急性胰腺炎患者的胃肠道功能不良评分越高,其APACHEⅡ评分(r=0.612,P=0.028)和CTSI评分(r=0.477,P=0.006)也越高,且ICU住院天数(r=0.640,P=0.035)及呼吸机使用天数(r=0.779,P=0.022)与胃肠道功能中重度不良天数呈正相关。胃肠道中重度不良患者中重症胰腺炎比例更高(χ2=4.367,P=0.037)。结论胃肠道功能可反映急性胰腺炎患者病情严重程度。展开更多
Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomo...Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.展开更多
文摘目的探讨胃肠道功能与急性胰腺炎病情严重程度的关系。方法回顾性总结我科2001年9月-2012年8月成功救治的42例急性胰腺炎患者的临床资料。将患者胃肠道功能按严重程度进行评分,同时评测患者入院当天的急性生理及慢性健康状况评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)和CT严重度指数(computer tomography severityindex,CTSI)评分,将胃肠道功能中重度不良天数与ICU住院天数、呼吸机使用天数进行相关性分析。比较胃肠道中重度不良组与轻度不良组中重症患者比例。结果急性胰腺炎患者的胃肠道功能不良评分越高,其APACHEⅡ评分(r=0.612,P=0.028)和CTSI评分(r=0.477,P=0.006)也越高,且ICU住院天数(r=0.640,P=0.035)及呼吸机使用天数(r=0.779,P=0.022)与胃肠道功能中重度不良天数呈正相关。胃肠道中重度不良患者中重症胰腺炎比例更高(χ2=4.367,P=0.037)。结论胃肠道功能可反映急性胰腺炎患者病情严重程度。
文摘Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.
