摘要
目的探讨彩色多普勒超声(CDFI)在重症胰腺炎诊断中的临床价值。方法选取新疆维吾尔自治区人民医院2014年1月至2018年1月收治的150例急性胰腺炎患者(AP),根据《中国急性胰腺炎诊治指南2013年版》标准,其中普通AP患者95例(轻症组)、急性重症胰腺炎患者55例(重症组),对比两组患者的CDFI超声影像特征,并分析胰腺炎超声评分与急性生理功能与慢性健康评分(APACHEⅡ)的关系。结果重症组患者的胰腺弥漫性增大(61.82%)、胰腺轮廓模糊(72.73%)、胰腺实质出现片状低-无回声(47.27%)、网膜囊增厚(25.45%)、胰腺周围积液(60.00%)的发生率均高于轻症急性胰腺炎患者(17.89%,43.16%,13.68%,7.37%,14.74%),差异具有统计学意义(P<0.05);重症组患者的超声评分[(7.35±1.52)分]、APACHEⅡ评分[(18.7±5.5)分]高于轻症急性胰腺炎患者[(4.41±1.33)分,(6.2±1.5)分],差异具有统计学意义(P<0.05);重症组患者的超声评分与APACHEⅡ评分呈正相关(r=0.669,P<0.01)。超声鉴别诊断重症急性胰腺炎与轻症急性胰腺炎的灵敏度为83.64%、特异度为74.74%、漏诊率为16.36%、误诊率为25.26%。结论CDFI作为一种无创、快速的诊断方式,在急性胰腺炎患者病情鉴别中具有一定的临床实用价值。
Objective To explore the clinical value of color doppler ultrasound(CDFI)in the diagnosis of severe pancreatitis.Methods 150 patients with acute pancreatitis(AP)admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2014 to January 2018 were selected according to the"2013 Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China".Among them,95 patients with common AP(mild group)and 55 patients with severe AP(severe group).The CDFI ultrasound imaging characteristics of the two groups were compared,and the relationship between the ultrasound score of pancreatitis and acute physiological function and chronic health score(APACHEⅡ)was analyzed.Results The incidence of diffuse pancreatic enlargement(61.82%),blurred pancreatic contour(72.73%),lamellar hypoechoic pancreatic parenchyma(47.27%),thickening of omental sac(25.45%),peripancreatic effusion(60.00%)in severe group was higher than that in mild acute pancreatitis(17.89%,43.16%,13.68%,7.37%,14.74%),with statistically significant difference(P<0.05).In the severe group,the ultrasound score(7.35±1.52)and the APACHEⅡscore(18.7±5.5)were higher than those with mild acute pancreatitis(4.41±1.33,6.2±1.5),and the difference was statistically significant(P<0.05);there was a significant positive correlation between the ultrasound score and the APACHEⅡscore in the severe group(r=0.669,P<0.01).The sensitivity,specificity,missed diagnosis rate and misdiagnosis rate were 83.64%,74.74%,16.36%and 25.26%respectively.Conclusions As a non-invasive and rapid diagnosis method,CDFI has certain clinical practical value in the identification of patients with acute pancreatitis.
作者
木塔里甫·买合木提
郭峻氚
肖东
Mutalifu Maihemuti;Guo Junchuan;Xiao Dong(Department 2 of Critical Medicine,Xinjiang Uygur Autonomous Region People's Hospital,Xinjiang 830001,China)
出处
《中国医师杂志》
CAS
2020年第4期517-520,共4页
Journal of Chinese Physician
