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

发布时间：2018-06-18 01:13

本文选题：急性胰腺炎 + 腹部CT　；参考：《安徽医药》2016年02期

【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(P0.05),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(P0.05);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,P0.05)。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。
[Abstract]:Objective to evaluate the value of abdominal CT scan in the diagnosis and prognosis of complications of acute pancreatitis. Methods the clinical history and CT imaging findings of 731 patients with acute pancreatitis were retrospectively analyzed. 104 patients with acute pancreatitis underwent plain CT scan at the same time and the severity of the disease was evaluated by Bahhazar-CTSI scoring system. To analyze the relationship between CT plain scan and complications and death in patients with acute pancreatitis. Results the incidence of complications in the patients with acute pancreatitis was 48.6 and the mortality was 3.9.Logistic regression analysis showed that obesity, moderate fatty liver, severe fatty liver, invasion of the bare area of stomach, accumulation of fluid in the superior hepatic space, Adrenal invasion and perirenal space invasion were independent risk factors for complications in patients with acute pancreatitis. Superhepatic space effusion and adrenal invasion were independent risk factors for death in patients with acute pancreatitis P0.05.The sensitivity, specificity and accuracy of the logistic regression model for the diagnosis of complications in patients with acute pancreatitis were 82.0, 90.7, 86.5 and 86.5, respectively. The sensitivity, specificity and Spearman grade correlation analysis showed that CTSI score was positively correlated with the risk factors for predicting complications and death in patients with acute pancreatitis, the specificity was 98.9% and the accuracy rate was 96.4% and Spearman grade correlation analysis showed that there was a positive correlation between CTSI score and the risk factors for predicting complications and death in patients with acute pancreatitis (P 0.05). Conclusion abdominal CT scan can reflect the involvement of peripancreatic tissues and organs in patients with acute pancreatitis, and the involvement of surrounding tissues and organs is closely related to the complications and death of the patients. It can be used to evaluate the condition and prognosis of patients with acute pancreatitis.
【作者单位】：汉中市中心医院放射科;
【分类号】：R576;R816.5

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