重症胰腺炎CT诊断和临床应用价值

目的：探讨重症胰腺炎（SAP）的CT表现和局部并发症的特点及临床治疗的关系。方法：回顾分析32例经手术病理和临床证实SAP病例的临床CT资料，均行CT平扫，12例行增强扫描，13例多次复查。胰腺区域采用薄层扫描，按CT影像学分级后结合临床发病特点和治疗方案以及预后进行分析。结果：所有病例均有不同程度胰腺肿大，早期均并发胰周液体积聚，后期并发症中有：假性囊肿（10／32）、蜂窝组织炎（8／32）、脓肿（2／32）、假性动脉瘤（1，32）；D级23例，8例后期有并发症，E级9例，全部有后期并发症，非手术治疗19例，手术治疗13例。结论：SAP是一种病程和预后复杂多变、并发症多且死亡率高的外科急腹症。CT检查能够早期识别SAP及并发症，对临床正确诊断和制定治疗方案以及监测病情发展有重要意义。

CT diagnosis and its clinical application value of severe acute pancreatitis

Objective：To investigate the CT manifestations characteristics of local complications,and their relation with clinical treatment in severe acute pancreatitis（SAP）.Methods：To retrospective, analyse the clinical CT data of 32 cases with severe acute pancreatitis confirmed by surgery and pathology and clinical cases ofaU patients underwent CT scan, 12 patients enhanced scan, 13 cases of multiple review, pancreatic region using TLC.According to CT imaging combined with clinical onset after grading characteristics and treatment options and prognosis,the analysis was performed.Results：All patients had varying degrees of swelling of the pancreas,pancreatic fluid collection in early stage.The late complications were ：pseudocysts （10/32）,cellulitis （8/32）,abscess （2/32）,pseudo-aneurysm （1/32）.in 23 cases of D grade,there were eight cases of late complications,in 9 cases E Grade,all had late complications.Non-surgical treatment was 19 cases,surgical treatment in 13 cases.Conclusion： Severe pancreatitis is a surgical acute abdomen with complex course of the disease and prognosis,many complications and high mortality rate.CT examination can early identify severe pancreatitis and complications, which has impartant significance for drawing up the clinical diagnosis and treatment plan and monitoring progression of the disease.