[1]李焕根,黄鸣恋,黄幼佩,等.CT评估急性重症胰腺炎及肝脏损害的应用价值[J].中国医学物理学杂志,2022,39(3):311-316.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.009]
　LI Huangen,HUANG Minglian,HUANG Youpei,et al.Role of CT in assessing severe acute pancreatitis and liver damage[J].Chinese Journal of Medical Physics,2022,39(3):311-316.[doi:DOI:10.3969/j.issn.1005-202X.2022.03.009]
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CT评估急性重症胰腺炎及肝脏损害的应用价值()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
39卷
期数:
2022年第3期
页码:
311-316
栏目:
医学影像物理
出版日期:
2022-03-28

文章信息/Info

Title:
Role of CT in assessing severe acute pancreatitis and liver damage
文章编号:
1005-202X（2022）03-0311-06
作者:
李焕根; 黄鸣恋; 黄幼佩; 郑文博; 陈伟文
福建医科大学附属泉州第一医院， 福建 泉州 362000
Author(s):
LI Huangen;  HUANG Minglian;  HUANG Youpei;  ZHENG Wenbo;  CHEN Weiwen
Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, China
关键词:
计算机断层扫描; 急性重症胰腺炎; 感染; 肝脏损害; 降钙素原; C反应蛋白
Keywords:
Keywords: computed tomography acute severe pancreatitis infection liver damage procalcitonin C-reactive protein
分类号:
R657.51
DOI:
DOI:10.3969/j.issn.1005-202X.2022.03.009
文献标志码:
A
摘要:
目的：分析计算机断层扫描（CT）评估急性重症胰腺炎（SAP）患者及肝脏损害的临床应用价值。方法：84名SAP患者根据病情分级为轻型组（n=36）和重型组（n=48），其中重型组接受CT引导的经皮导管引流（PCD）术。分析两组CT影像学特征、血清C反应蛋白（CRP）及降钙素原（PCT）以及治疗前后二者水平与肝脏密度CT值的相关性。结果：重型组患者CT影像学示胰腺片状坏死、气泡、多区域胰液潴留、脂肪层模糊不清以及体积增大检出率均显著高于轻型组（P<0.05）。CT示高脂血症致胰腺炎患者胰腺坏死范围30%~50%，周围积液、渗出，尾部肿大，片状坏死。CT示急性胰腺炎患者胰腺坏死范围>50%，双侧胸腔积液，周围脓肿形成。重型组血清CRP与PCT水平均显著高于轻型组（P<0.05）；治疗前，重型组肝脏CT值显著低于轻型组（P<0.05），治疗后，两组肝脏CT值比较差异无统计学意义（P>0.05）。治疗前，重型组肝脏CT值与PCT、CRP水平均呈显著负相关性（r=-0.643, r=-0.568；P<0.05）；治疗后，重型组肝脏CT值与PCT、CRP水平均无显著相关性（r=-0.084, r=-0.056；P>0.05）。重型组患者治疗时间显著长于轻型组（P<0.05），治愈率低于轻型组，死亡率高于轻型组（P<0.05）。结论：CT可以有效评估SAP并发细菌感染患者的严重程度，且通过直观观察肝脏密度改变评估SAP患者肝脏损伤情况。
Abstract:
Abstract: Objective To analyze the clinical application value of computed tomography (CT) in the assessment of severe acute pancreatitis (SAP) and liver damage. Methods Eighty-four SAP patients were classified into mild group (n=36) and severe group (n=48) according to their condition, and the severe group accepted CT-guided percutaneous catheter drainage (PCD). The CT imaging characteristics were analyzed, and the correlations of serum C-reactive protein (CRP) and procalcitonin (PCT) levels to liver CT value (HU) in two groups before and after treatment were discussed. Results CT imaging findings showed that the detection rates of pancreatic flaky necrosis, air bubbles, multi-regional pancreatic juice retention, obscured fat layer and volume increase in severe group were significantly higher than those in mild group (P<0.05). CT images showed that pancreatic necrosis area in patients with pancreatitis caused by hyperlipidemia ranged from 30% to 50%, with surrounding fluid and exudation, swelling of the tail, and flaky necrosis, and that the necrosis area in patients with acute pancreatitis was larger than 50%, with bilateral pleural effusion, and peripheral abscess formation. Serum CRP and PCT levels of severe group were significantly higher than those of mild group (P<0.05). Before treatment, the liver HU of severe group was significantly lower than that of mild group (P<0.05), but the difference between two groups in liver HU after treatment was trivial (P>0.05). Before treatment, the liver HU of severe group was negatively correlated with PCT and CRP levels (r=-0.643, r=-0.568 P<0.05) after treatment, there was no significant correlation between liver HU and PCT or CRP level (r=-0.084, r=-0.056 P>0.05). Compared with mild group, severe group had obviously longer treatment duration, lower cure rate and higher mortality rate (all P<0.05). Conclusion CT can be used to effectively assess the severity of SAP co-infected patients, and to observe the changes in liver density, thereby assessing liver damage in SAP patients.

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备注/Memo

备注/Memo:
【收稿日期】2021-08-21 【基金项目】泉州市科技计划项目（2018N070S） 【作者简介】李焕根，副主任医师，研究方向：腹部重症、重症感染、血流动力学，E-mail: wangliwangli150@163.com 【通信作者】陈伟文，主任医师，研究方向：呼吸危重症、重症感染、血流动力学，E-mail: 345875567@qq.com
更新日期/Last Update: 2022-03-28