胰腺外积液的存在和程度是严重急性胰腺炎的指标。

P G Lankisch, K Struckmann, D Lehnick
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引用次数: 38

摘要

背景:有研究表明,通过增强计算机断层扫描(CT)早期定位坏死和胰腺外积液可以预测严重急性胰腺炎的预后。对这两个假设进行了评估。患者和方法:本研究纳入了1987年至1995年收治的228例首次发作的急性胰腺炎患者,并对入院后72小时内的对比增强CT的预后价值进行了前瞻性评估。回顾性地重新评估这些ct以确定胰腺坏死和胰腺外积液的定位。以透析和人工通气的指征、胰腺假性囊肿的发展、手术的必要性(坏死切除术)和死亡率作为临床参数。结果:胰腺坏死和胰外液的存在与临床参数有显著的相关性。胰腺坏死的局部化对疾病的预后不重要,而胰腺外积液的增加与急性胰腺炎的严重程度平行。结论:胰腺坏死和胰外液收集是判断重症急性胰腺炎的指标。虽然胰腺坏死的部位对疾病的预后并不重要,但胰腺外液收集的程度与病程的严重程度显著相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Presence and extent of extrapancreatic fluid collections are indicators of severe acute pancreatitis.

Background: It has been suggested that early localization of both necrosis and extrapancreatic fluid collections by contrast-enhanced computed tomography (CT) can predict the outcome in severe acute pancreatitis. These two assumptions were evaluated.

Patients and methods: This study comprises 228 patients with a first attack of acute pancreatitis admitted to our clinic from 1987 to 1995 and for whom the prognostic value of a contrast-enhanced CT obtained within 72 h of admission was prospectively evaluated. These CTs were retrospectively re-evaluated for the localization of pancreatic necrosis and extrapancreatic fluid collections. The indication for dialysis and artificial ventilation, the development of pancreatic pseudocysts, the necessity for surgery (necrosectomy), and mortality were used as clinical parameters.

Results: There was a significant correlation between the presence of pancreatic necrosis and extrapancreatic fluid collections versus the clinical parameters. The localization of pancreatic necrosis was of no importance for the outcome of the disease, whereas the increasing amount of extrapancreatic fluid collections paralleled the severity of acute pancreatitis.

Conclusion: Pancreatic necrosis and extrapancreatic fluid collections are indicators for severe acute pancreatitis. Whereas the localization of pancreatic necrosis is not important for the outcome of the disease, the extent of extrapancreatic fluid collections is significantly correlated with a severe course.

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