CAJ | 학술논문

目的探讨重症急性胰腺炎(SAP)并发腹腔间室综合征(ACS)患者的CT特征.方法回顾性对比分析2005年3月至2013年3月江苏省苏北人民医院36例SAP并发ACS患者(观察组)和61例非ACS(NACS)的SAP患者(对照组)的CT资料,探讨有意义的CT特征.结果本组36例ACS患者和61例NACS患者,CT扫描,ACS血管并发症包括腹腔及消化道出血的发生率高于NACS(P＜0.05).ACS并发纹窄性肠梗阻及肠系膜炎的发生率高于NACS(P ＜0.05).ACS下腔静脉受压、狭窄(＜3 mm),膈肌上抬、圆腹征阳性及大量腹腔积液的发生率高于NACS(P＜0.05).ACSBalthazar CT评分(CT SI)高于NACS(P＜0.05).与ACS有关的CT征象,出现≥4项有关ACS的CT特征,诊断敏感度96.5％ (28/29),特异度100％ (7/7),阳性预测值100％ (28/28),阴性预测值87.5％(7/8),手术存活率远高于非手术存活率(P＜0.05).结论 SAP合并ACS患者有一定的CT特征,充分认识此类征象,可为患者早期诊断及治疗起到积极地指导作用.
목적 탐토중증급성이선염(SAP)병발복강간실종합정(ACS)환자적CT특정.방법 회고성대비분석2005년3월지2013년3월강소성소북인민의원36례SAP병발ACS환자(관찰조)화61례비ACS(NACS)적SAP환자(대조조)적CT자료,탐토유의의적CT특정.결과 본조36례ACS환자화61례NACS환자,CT소묘,ACS혈관병발증포괄복강급소화도출혈적발생솔고우NACS(P＜0.05).ACS병발문착성장경조급장계막염적발생솔고우NACS(P ＜0.05).ACS하강정맥수압、협착(＜3 mm),격기상태、원복정양성급대량복강적액적발생솔고우NACS(P＜0.05).ACSBalthazar CT평분(CT SI)고우NACS(P＜0.05).여ACS유관적CT정상,출현≥4항유관ACS적CT특정,진단민감도96.5％ (28/29),특이도100％ (7/7),양성예측치100％ (28/28),음성예측치87.5％(7/8),수술존활솔원고우비수술존활솔(P＜0.05).결론 SAP합병ACS환자유일정적CT특정,충분인식차류정상,가위환자조기진단급치료기도적겁지지도작용.
Objective To explore the computed tomographic (CT) imaging features of abdominal compartment syndrome (ACS) complicated by severe acute pancreatitis (SAP) to improve the diagnosis of disease.Methods Thirty-six cases of ACS and 61 cases of non-ACS (NACS) complicated by SAP were studied retrospectively.And the meaningful CT features were studied.Results Among them,the ACS vascular complications of abdominal cavity and gastrointestinal bleeding were found significantly more in ACS than in NACS (P ＜ 0.05).The ACS intestinal obstruction occurred significantly more often in ACS than in NACS (P ＜ 0.05).The ACS inferior vena cava pressure,diaphragm elevation,round belly sign and marked seroperitoneum occurred significantly more often in ACS than in NACS (P ＜ 0.05).The score of ACS with Balthazar was higher than that of NACS (P ＜ 0.05).For CT signs associated with ACS,four or more associated with ACS CT characteristics,the diagnostic sensitivity was 96.5％.And the specificity,positive predictive value and negative predictive value were 100％,100％ and 87.5％ respectively.And the surgical survival rate was significantly higher than the non-surgical survival (P ＜ 0.05).Conclusion A comprehensive analysis CT features of ACS is important for early diagnosis and guiding treatment.