天津医药

天津医药 ›› 2023, Vol. 51 ›› Issue (11): 1242-1244.doi: 10.11958/20230197

• 临床研究 • 上一篇    下一篇

腹膜后间隙炎症浸润、胸腔积液、胰周积液评估急性胰腺炎严重度的临床价值

徐玉龙(), 叶淳娟, 谈冰   

  1. 安徽省第二人民医院急诊医学科（邮编230041）
  • 收稿日期:2023-02-16 修回日期:2023-03-03 出版日期:2023-11-15 发布日期:2023-11-07
  • 作者简介:徐玉龙（1975），男，副主任医师，主要从事急危重症方面研究。E-mail：xuyulong1116@163.com
  • 基金资助:
    安徽省卫生计生委科研计划项目(2018SEYL018)

Clinical value of retroperitoneal space inflammatory infiltration, pleural effusion and peripancreatic effusion in evaluating the severity of acute pancreatitis

XU Yulong(), YE Chunjuan, TAN Bing   

  1. Department of Emergency Medicine, Anhui No.2 Provincial People’s Hosptial, Hefei 230041, China
  • Received:2023-02-16 Revised:2023-03-03 Published:2023-11-15 Online:2023-11-07

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摘要：

目的 探讨腹膜后间隙（RPS）炎症浸润、胸腔积液、胰周积液评估急性胰腺炎（AP）严重度的临床价值。方法 回顾性分析108例AP患者并对其进行CT严重指数（CTSI）分级与RPS炎症浸润程度分级，明确RPS炎症浸润程度、胸腔积液、胰周积液与AP临床严重度的相关性。结果 根据CTSI分级，Ⅰ级AP患者53例，RPS炎症浸润程度以A级为主，早期（发病后48 h内）胸腔积液检出率11.32%，胰周积液发生率54.72%，胰周积液数量以1个为主；Ⅱ级AP患者31例，RPS炎症浸润程度以C级为主，早期胸腔积液检出率38.71%，胰周积液发生率为80.65%，胰周积液数量以1~2个为主；Ⅲ级AP患者24例，RPS炎症浸润程度以D级为主，早期胸腔积液检出率为70.83%，胰周积液发生率为95.83%，胰周积液数量3个及以上为主。AP患者RPS炎症浸润程度、早期胸腔积液检出与CTSI分级呈正相关（rs分别为0.818、0.990，均P<0.05）；AP患者胰周积液数量随CTSI分级升高而增加。结论 RPS炎症浸润程度、胸腔积液、胰周积液与急性胰腺炎临床严重度紧密相关，临床应该足够重视。

关键词: 胰腺炎, 胸腔积液, 腹膜后间隙, 炎症浸润, 胰周积液, CT严重度指数

Abstract:

Objective To explore the clinical value of retroperitoneal space (RPS) inflammatory infiltration, pleural effusion and peripancreatic effusion in evaluating the severity of acute pancreatitis (AP). Methods A retrospective analysis was conducted on 108 patients with AP, and their CT severity index (CTSI) grading and RPS inflammatory infiltration grading were performed to clarify the correlation between RPS inflammatory infiltration, pleural effusion, peripancreatic effusion and clinical severity of AP. Results According to the CTSI grading, 53 AP patients with grade Ⅰ AP were diagnosed, and the degree of RPS inflammation infiltration was mainly grade A. The detection rate of pleural effusion in the early stage (within 48 hours after the onset) was 11.32%, the incidence of peripancreatic effusion was 54.72%, and the number of peripancreatic effusion was mainly 1. Of the 31 AP patients with grade Ⅱ, the degree of RPS inflammatory infiltration was mainly grade C. The detection rate of early pleural effusion was 38.71%, the incidence of peripancreatic effusion was 80.65%, and the number of peripancreatic effusion was mainly 1 or 2. There were 24 AP patients with grade Ⅲ and the degree of RPS inflammatory infiltration was mainly grade D. The detection rate of early pleural effusion was 70.83%, the incidence of peripancreatic effusion was 95.83%, and the number of peripancreatic effusion was 3 or more. The degree of RPS inflammatory infiltration and the detection rate of early pleural effusion in AP patients were positively correlated with the CTSI grade (rs=0.818, P<0.05; rs=0.990, P<0.05). The number of peripancreatic effusion in AP patients increased with the increase of CTSI grade. Conclusion The degree of RPS inflammatory infiltration, pleural effusion and peripancreatic effusion are closely related to the clinical severity of acute pancreatitis, and should be given sufficient attention in clinical practice.

Key words: pancreatitis, pleural effusion, retroperitoneal space, inflammatory infiltration, peripancreatic effusion, CT severity index

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