| 夏雨.腹部CT扫描在急性胰腺炎并发症诊断及预测预后中的价值[J].安徽医药,2016,20(2):328-331. |
| 腹部CT扫描在急性胰腺炎并发症诊断及预测预后中的价值 |
| Values of abdominal CT scans in diagnostic of complications and prognostic of patients with acute pancreatitis〖WT5BZXIA Yu (Department of Radiology,Hanzhong Central Hospital,Hanzhong,Shananxi 723000) Abstract:Objective |
| 投稿时间：2015-09-07 |
| DOI： |
| 中文关键词: 急性胰腺炎 腹部CT 并发症 预测 预后 |
| 英文关键词: acute pancreatitis abdominal CT complication prediction prognosis |
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| 中文摘要: |
| 目的 探讨腹部CT扫描在急性胰腺炎并发症诊断及预测预后中的价值。方法 回顾性分析731例急性胰腺炎患者临床病史及CT影像学检查结果,其中,104例患者行CT平扫同时进行增强,利用Bahhazar-CTSI评分系统对患者病情严重程度进行评估。分析CT平扫表现与急性胰腺炎患者并发症及死亡之间的关系。结果 急性胰腺炎患者中并发症发生率48.6%,病死率3.9%。Logistic回归分析显示,肥胖、中度脂肪肝、重度脂肪肝、胃裸区受侵、肝上间隙积液、肾上腺受侵和肾周间隙受侵均是急性胰腺炎患者发生并发症的独立危险因素(P<0.05),肥胖、胃裸区受侵、肝上间隙积液和肾上腺受侵是急性胰腺炎患者发生死亡的独立危险因素(P<0.05)；构建的Logistic回归模型诊断急性胰腺炎患者发生并发症的灵敏度82.0%、特异度90.7%,正确率86.5%,诊断急性胰腺炎患者发生死亡的灵敏度37.9%、特异度98.9%,正确率96.4%；Spearman等级相关分析显示,CTSI评分与预测患者发生并发症及死亡的相关危险因素呈正相关(r=0.893,P<0.05)。结论 腹部CT扫描可反映急性胰腺炎患者胰腺周围组织和器官受累情况,且周围组织和器官受累与患者并发症及死亡发生密切相关,可用于急性胰腺炎患者病情及预后的评估。 |
| 英文摘要: |
| Objective To investigate the values of abdominal CT scans in diagnostic of complications and prognostic of patients with acute pancreatitis.Methods The clinical data and CT imaging findings of 731 cases of patients with acute pancreatitis were retrospective analyzed.Among which,104 patients were undergoing CT scan and enhanced,and the severity of the patients′ conditions were assessed by using Balthazar-CTSI scoring system.The general information,such as age,gender,body mass index,etc,of the patients was recorded.The occurrences of stomach bare area involvement,fatty liver,liver gap effusion,pleural effusion,adrenal involvement,perirenal space involvement were observed by analyzing CT scan shown.The relationship between these manifestations and complications and death in patients with acute pancreatitis were analyzed.Results The incidence of complications in patients with acute pancreatitis was 48.6% and mortality was 3.9%.Univariate analysis showed that complications and deaths of patients with acute pancreatitis were related with body mass index,fatty liver,stomach bare area involvement,liver gap effusion,adrenal involvement and perirenal space involvement (P<0.05).Logistic regression analysis showed that obesity,moderate fatty liver,severe fatty liver,stomach bare area involvement,liver gap effusion,adrenal involvement and perirenal space involvement were independent risk factors for the occurrence of complications in patients with acute pancreatitis (P<0.05),and obesity,gastric bare area involvement,liver and adrenal involvement gap effusion is an independent risk factor for death in patients with acute pancreatitis (P<0.05).Diagnosis of acute pancreatitis complications by using constructed Logistic regression models,the sensitivity was 82.0%,specificity was 90.7% and accuracy rate was 86.5%,and for mortality was 37.9%,98.9% and 96.4%.The incidences of complications and death in defferent CTSI score groups were different,and risk factor scores were also different,the differences were statistically significant (P<0.05).Spearman rank correlation analysis showed that the CTSI scores were positive correlation with the risk factors associated complications and death in patients with acute pancreatitis (r=0.893,P<0.05).Conclusions Abdominal CT scans of patients with acute pancreatitis could reflect the involvement of pancreatic surrounding tissues and organs.And the surrounding tissue and organ involvement were closed related with the complications and deaths.It could be used to assess the condition and prognosis of patients with acute pancreatitis. |
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