中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
12期
937-940
,共4页
吴东%芦波%杨红%李景南%钱家鸣
吳東%蘆波%楊紅%李景南%錢傢鳴
오동%호파%양홍%리경남%전가명
胰腺炎%回顾性研究%预后%中度急性胰腺炎%重度急性胰腺炎%危重急性胰腺炎
胰腺炎%迴顧性研究%預後%中度急性胰腺炎%重度急性胰腺炎%危重急性胰腺炎
이선염%회고성연구%예후%중도급성이선염%중도급성이선염%위중급성이선염
Pancreatitis%Retrospective studies%Prognosis%Moderate severe acute pancreatitis%Severe acute pancreatitis%Critical acute pancreatitis
目的 探讨重症急性胰腺炎三分类方法的临床应用价值.方法 回顾性分析2001年1月至2012年12月收治的337例传统分类为重症急性胰腺炎患者的临床资料,按2013年新亚特兰大分类标准将其分为中度急性胰腺炎(MSAP)和重度急性胰腺炎(SAP),并将SAP进一步分为危重急性胰腺炎(CAP)和非CAP.比较MSAP、非CAP和CAP患者的病情、治疗及预后.结果 337例重症急性胰腺炎患者包括253例MSAP和84例SAP,其中SAP组包括CAP40例和非CAP44例.CAP亚组与非CAP亚组的院内病死率[70.0％(28/40)比22.7％(10/44)]、入住ICU比例[77.5％(31/40)比56.8％ (25/44)]、平均ICU住院时间[(15.5±20.6)d比(5.6±11.0)d]、Ranson评分[(4.6±1.4)分比(3.9±1.6)分]、急性生理与慢性健康评分Ⅱ(APACHEⅡ)[(16.8±5.8)分比(13.9±7.3)分]、修正的CT严重指数(MCTSI)[(8.6±1.7)分比(7.4±2.7)分]、修正的Marshall评分[(7.4±2.9)分比(3.6±2.3)分]比较,差异均有统计学意义(P均＜0.01).SAP组的上述指标亦均显著高于MSAP组(P均＜0.01).结论 将传统重症急性胰腺炎分为MSAP、SAP和CAP3类有利于更准确地反映病情严重程度,判断预后并指导临床治疗.
目的 探討重癥急性胰腺炎三分類方法的臨床應用價值.方法 迴顧性分析2001年1月至2012年12月收治的337例傳統分類為重癥急性胰腺炎患者的臨床資料,按2013年新亞特蘭大分類標準將其分為中度急性胰腺炎(MSAP)和重度急性胰腺炎(SAP),併將SAP進一步分為危重急性胰腺炎(CAP)和非CAP.比較MSAP、非CAP和CAP患者的病情、治療及預後.結果 337例重癥急性胰腺炎患者包括253例MSAP和84例SAP,其中SAP組包括CAP40例和非CAP44例.CAP亞組與非CAP亞組的院內病死率[70.0％(28/40)比22.7％(10/44)]、入住ICU比例[77.5％(31/40)比56.8％ (25/44)]、平均ICU住院時間[(15.5±20.6)d比(5.6±11.0)d]、Ranson評分[(4.6±1.4)分比(3.9±1.6)分]、急性生理與慢性健康評分Ⅱ(APACHEⅡ)[(16.8±5.8)分比(13.9±7.3)分]、脩正的CT嚴重指數(MCTSI)[(8.6±1.7)分比(7.4±2.7)分]、脩正的Marshall評分[(7.4±2.9)分比(3.6±2.3)分]比較,差異均有統計學意義(P均＜0.01).SAP組的上述指標亦均顯著高于MSAP組(P均＜0.01).結論 將傳統重癥急性胰腺炎分為MSAP、SAP和CAP3類有利于更準確地反映病情嚴重程度,判斷預後併指導臨床治療.
목적 탐토중증급성이선염삼분류방법적림상응용개치.방법 회고성분석2001년1월지2012년12월수치적337례전통분류위중증급성이선염환자적림상자료,안2013년신아특란대분류표준장기분위중도급성이선염(MSAP)화중도급성이선염(SAP),병장SAP진일보분위위중급성이선염(CAP)화비CAP.비교MSAP、비CAP화CAP환자적병정、치료급예후.결과 337례중증급성이선염환자포괄253례MSAP화84례SAP,기중SAP조포괄CAP40례화비CAP44례.CAP아조여비CAP아조적원내병사솔[70.0％(28/40)비22.7％(10/44)]、입주ICU비례[77.5％(31/40)비56.8％ (25/44)]、평균ICU주원시간[(15.5±20.6)d비(5.6±11.0)d]、Ranson평분[(4.6±1.4)분비(3.9±1.6)분]、급성생리여만성건강평분Ⅱ(APACHEⅡ)[(16.8±5.8)분비(13.9±7.3)분]、수정적CT엄중지수(MCTSI)[(8.6±1.7)분비(7.4±2.7)분]、수정적Marshall평분[(7.4±2.9)분비(3.6±2.3)분]비교,차이균유통계학의의(P균＜0.01).SAP조적상술지표역균현저고우MSAP조(P균＜0.01).결론 장전통중증급성이선염분위MSAP、SAP화CAP3류유리우경준학지반영병정엄중정도,판단예후병지도림상치료.
Objective To evaluate the clinical value of the three-category classification of severe acute pancreatitis (SAP).Methods Clinical data of 337 traditional SAP patients,who were admitted to Peking Union Medical College Hospital (PUMCH)from January 2001 to December 2012,were retrospectively studied.These patients were classified into moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP) according to the latest 2013 Atlanta Classification.SAP patients were further categorized as critical acute pancreatitis (CAP) and non-CAP.Disease severity,therapy and prognosis among three groups were compared.Results Among the total 337 traditional SAP patients,253 were classified as MSAP and 84 as SAP.In the group of SAP,40 patients were categorized as CAP and 44 as non-CAP.Compared with non-CAP patients,CAP patients had significantly higher mortality rate which was 70％ (28/40).Other results were all significantly higher in CAP group rather than non-CAP group,including ICU admission rate 77.5％(31/40),length of ICU stay (15.5 ± 20.6) days,Ranson,APACHE Ⅱ,BISAP,MCTSI,modified Marshall scores 4.6 ± 1.4,16.8 ± 5.8,3.0 ± 1.0,8.6 ± 1.7,and 7.4 ± 2.9,respectively (P ＜ 0.01 in each endpoint).These parameters of SAP group were also significantly higher than those of MSAP group (P ＜0.01).Conclusions Using the new three-category classification to distinguish traditional severe acute pancreatitis,namely MSAP,SAP,and CAP,can better reflect the severity of disease,predict outcome and guide clinical management.
