CT评分与急性胰腺炎伴心包积液的相关性研究

目的 研究急性胰腺炎（AP）向纵隔扩散致心包腔积液的多排螺旋CT表现及其与急性胰腺炎CT指数（CTSI）、休克、死亡率的相关性。方法 回顾性分析2017年7月~2018年6月我院收治的274例AP患者，入院行CT，观察患者心包积液发生率，测量其厚度；用CTSI分级评估AP严重程度并分析心包积液与CTSI、休克率及死亡率之间的关系。结果 CTSI评分轻、中、重度AP患者分别占43.07%、53.28%、3.65%；胰周积液向纵隔扩散时54例（19.71%）食管裂孔受累，10例（3.65%）主动脉裂孔受累，6例（2.19%）下腔静脉裂孔受累；34例（12.41%）患者并发心包积液，心包积液厚度与CTSI正相关（r=0.40，P＜0.05）；患者休克发生率、死亡率分别为16.42%、1.46%；AP并心包积液患者休克发生率、死亡发生率均高于无心包积液患者，差异有统计学意义（P＜0.05）。结论 AP伴心包积液发生率较低，胰周积液可经膈肌裂孔向纵隔扩散。心包积液可做为评价AP严重程度的辅助指标。

Reasearch on the Correlation between CT Score and Acute Pancreatitis with Pericardial Effusion

Abstract:Objective To study the multi-slice spiral CT findings of acute pancreatitis (AP) to mediastinal diffusion-induced pericardial effusion and its correlation with CT index, shock and mortality of acute pancreatitis.Methods Retrospective analysis of 274 patients with AP admitted to our hospital from July 2017 to June 2018. CT was admitted to the hospital. The incidence of pericardial effusion was observed and the thickness was measured. The severity of AP was assessed by CTSI and the pericardial effusion was analyzed. The relationship between CTSI, shock rate and mortality.Results CTSI scores of mild, moderate, and severe AP patients accounted for 43.07%, 53.28%, and 3.65%, respectively; 54 cases (19.71%) of esophageal hiatus involvement in the peripancreatic effusion, and 10 (3.65%) aortic hiatus involvement, 6 cases (2.19%) had inferior vena cava tears; 34 (12.41%) patients had pericardial effusion, and the thickness of pericardial effusion was positively correlated with CTSI (r=0.40,P<0.05).The incidence of shock and mortality were 16.42%, 1.46%; AP and pericardial effusion patients with shock and mortality were higher than patients without pericardial effusion, the difference was statistically significant (P<0.05).Conclusion The incidence of AP with pericardial effusion is low, and the peripancreatic effusion can spread to the mediastinum through the diaphragmatic rupture. Pericardial effusion can be used as an auxiliary indicator to evaluate the severity of AP.