三种临床评分标准对急性胰腺炎预后的评估价值比较

被引：20

作者：

邹晓平

顾超

刘明东

李运红

钱铖

机构：

[1] 南京大学医学院附属鼓楼医院消化科

来源：

中华消化杂志 | 2007年 / 01期

关键词：

胰腺炎; 诊断,计算机辅助; 预后;

D O I：

暂无

中图分类号：

R686 [筋腱、韧带、滑囊疾病及损伤];

学科分类号：

1002 ; 100210 ;

摘要：

目的研究APACHEⅡ、Ranson、Balthazar CT严重指数(CT severity index,CTSI)三种临床评分标准对轻症及重症急性胰腺炎(AP)的评估价值。方法回顾性研究AP患者355例。分析各临床评分标准与禁食天数、住院天数的相关性。用受试者工作特征曲线(ROC曲线)分析各临床评分标准判断重症AP的敏感性和特异性,分析各临床评分标准对局部和全身并发症的预见能力。结果355例患者中,诊断轻症273例,重症82例。轻症和重症AP患者三种临床评分分值差异均有统计学意义(P<0.05)。三种临床评分分值与AP患者禁食天数、住院时间均显著相关。CTSI标准的敏感性最高为77%,曲线下面积(AUC)最大为0.85。CTSI对局部并发症预见能力最高,Ranson标准对全身并发症的预见能力最高。结论CTSI标准是临床判断重症AP最有效的指标,将三种临床评分标准结合起来能更准确地评估急性胰腺炎的预后。

引用

共 8 条

[1]

A comparison of the Ranson, Glasgow, and APACHE II scoring systems to a multiple organ system score in predicting patient outcome in pancreatitis[J] . Stephanie L. Taylor,Daniel L. Morgan,Kent D. Denson,Mary M. Lane,Larry R. Pennington.The American Journal of Surgery . 2005 (2)

[2] Early nonenhanced abdominal computed tomography can predict mortality in severe acute pancreatitis [J].

Spitzer, AL ;

Thoeni, RF ;

Barcia, AM ;

Schell, MT ;

Harris, HW .

JOURNAL OF GASTROINTESTINAL SURGERY, 2005, 9 (07) :928-933

[3] Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II and III scoring systems in predicting acute pancreatitis outcome [J].

Chatzicostas, C ;

Roussomoustakaki, M ;

Vardas, E ;

Romanos, J ;

Kouroumalis, EA .

JOURNAL OF CLINICAL GASTROENTEROLOGY, 2003, 36 (03) :253-260

[4]

Early prediction of acute pancreatitis: Prospective study comparing computed tomography scans, ranson, glasgow, acute physiology and chronic health evaluation II scores, and various serum markers[J] . John H. Robert,Jean Louis Frossard,Bernadette Mermillod,Claudio Soravia,Nouri Mensi,Marc Roth,Adrien Rohner,Antoine Hadengue,Philippe Morel.World Journal of Surgery . 2002 (5)

[5] Computed tomography severity index is a predictor of outcomes for severe pancreatitis [J].

Simchuk, EJ ;

Traverso, LW ;

Nukui, Y ;

Kozarek, RA .

AMERICAN JOURNAL OF SURGERY, 2000, 179 (05) :352-355

[6]

Prognostic indicators in acute pancreatitis: CT vs APACHE II[J] . J.T. De Sanctis,M.J. Lee,G.S. Gazelle,G.W. Boland,E.F. Halpern,S. Saini,P.R. Mueller.Clinical Radiology . 1997 (11)

[7]

APACHE II: A severity of disease classification system[J] . WILLIAM A. KNAUS,ELIZABETH A. DRAPER,DOUGLAS P. WAGNER,JACK E. ZIMMERMAN.Critical Care Medicine . 1985 (10)

[8]

APACHE—acute physiology and chronic health evaluation: a physiologically based classification system[J] . WILLIAM A. KNAUS,JACK E. ZIMMERMAN,DOUGLAS P. WAGNER,ELIZABETH A. DRAPER,DIANE E. LAWRENCE.Critical Care Medicine . 1981 (8)

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