中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (09): 816-819.

• 论著 • 上一篇    下一篇

重症急性胰腺炎合并腹腔间室综合征CT特征分析

孙加奎1，李维勤1，王中秋2，倪海滨1，童智慧1，童明敏2，叶向红1，李    宁1，黎介寿1   

  1. 1南京大学医学院临床学院 南京军区南京总医院全军普通外科研究所，江苏南京 210002；2南京军区南京总医院医学影像科，江苏南京 210002
  • 出版日期:2011-09-01 发布日期:2011-08-19

  • Online:2011-09-01 Published:2011-08-19

PDF

970

摘要：

目的    探讨重症急性胰腺炎（SAP）合并腹腔间室综合征（ACS）的CT特征及其临床意义。方法    对南京军区南京总医院全军普通外科研究所2008年1月至2011年5月收治的23例SAP合并ACS病人的CT特征进行回顾性分析，探讨ACS的CT特征及其对判断病情严重度的参考意义。结果    23例SAP合并ACS病人中治愈12例，其中经手术治愈9例。SAP合并ACS者其CT下腔静脉受压、膈肌上抬和圆腹征的发生率以及CT严重指数（CTSI）评分要明显高于非ACS病人，而ACS病人治疗前后CT下腔静脉受压、增强CT肠壁增厚和膈肌上抬的发生率亦存在显著差异。在有关ACS的7项CT特征中，出现项数≥3项者其确诊ACS后急性生理与慢性健康评分（APACHEII）、序贯性脏器功能衰竭评分（SOFA），病程期间机械通气（MV）时间、连续性肾脏替代治疗（CRRT）时间，死亡率等均显著增加。结论    SAP合并ACS病人CT下腔静脉受压、膈肌上抬和圆腹征的发生率以及CTSI评分要明显高于非ACS病人，且CT特征出现的项数对判断病人病情严重度亦具有一定的参考意义。

关键词: 重症急性胰腺炎, 腹腔间室综合征, CT

Abstract:

The CT features of patients with abdominal compartment syndrome complicated by severe acute pancreatitis         SUN Jia-kui*, LI Wei-qin, WANG Zhong-qiu, et al. *Medical School of Nanjing University, Institute of General Surgery, General Hospital of Nanjing Military Command, People’s Liberation Army, Nanjing 210002, China
Corresponding author：LI Wei-qin，E-mail: sunjiakui1985@163.com
Abstract    Objective    To evaluate the CT features and its’ clinical impact of abdominal compartment syndrome(ACS) complicated by severe acute pancreatitis(SAP).  Methods    A retrospective study was carried out on 23 cases of patients with ACS complicated by SAP admitted in our center from January 2008 to May 2011, to evaluate the CT features of ACS and its’ effect of assessing patients’ severity.  Results    The morbidity of ACS complicated by SAP in our center was 3.04%. In the 23 cases of patients, 12 cases was cured and 9 cases of them was cured by operation. The CTSI scores and the incidence of narrowing of inferior vena cava, elevation of the diaphragm, round belly sign was significant variable between the ACS and non-ACS patients. And the self-comparison of ACS patients showed that the incidence of narrowing of inferior vena cava, bowel wall thickening with contrast enhancement, elevation of the diaphragm was also significant variable. Among the seven CT features of ACS in previous articles, the frequency of those features had a significant variable in APACHEII、SOFA、MV days、CRRT days and mortality.  Conclusions    The CTSI scores and the incidence of narrowing of inferior vena cava, elevation of the diaphragm, round belly sign was significant variable between the ACS and non-ACS patients, and the frequency of CT features in previous articles also had a effect of assessing the ACS patients’ severity.

Key words: severe acute pancreatitis, abdominal compartment syndrome, CT