经修订的亚特兰大分级及与BISAP临床评分系统比较的胰腺炎严重程度计算机断层扫描评估

Srikanth Sagi, Keerthi Bharati
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引用次数: 0

摘要

背景:未经治疗的急性胰腺炎具有很高的发病率和死亡率。这是严重的胃肠急症。其发生率约为51.0%,可引起局部和全身问题。诊断通常包括实验室检查,如淀粉酶和脂肪酶以及超声检查。理想的影像学检查是对比增强CT扫描。本研究使用基于实验室和放射学调查的评分系统来确定临床进展和结果。方法:纳入诊断为急性胰腺炎并行计算机断层扫描的患者。根据影像学结果,这些患者的急性胰腺炎的类别和亚类别以及液体收集的类型使用修订的亚特兰大分类进行了描述。计算所有患者的BISAP评分。评估这些患者的临床结果是住院时间、死亡率、持续性器官衰竭的存在、感染的发生和干预的需要。最后,分析修订后的亚特兰大分类与BISAP评分之间的相关性,并与临床结果进行比较。结果:修订亚特兰大分级严重程度分级与BISAP评分的相关性分析,在n=57例轻度急性胰腺炎患者中n=56例,BISAP评分小于3分,只有1例BISAP评分大于或等于3分。在n=25例中重度急性胰腺炎患者中,n=20例BISAP评分小于3分,n=5例BISAP评分大于或等于3分。在n=08例重度急性胰腺炎患者中,n=3例BISAP评分小于3分,n=5例BISAP评分大于或等于3分。结论:通过将新的亚特兰大分类系统纳入日常实践,标准化命名和促进对急性胰腺炎各种影像学异常的适当记录成为可能。通过将新的亚特兰大分类与BISAP临床分级相结合,我们可以更精确地对急性胰腺炎患者进行分诊、预测和治疗,显著改善医疗护理。
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Assessment of Severity of Pancreatitis by Computerized Tomography Using Revised Atlanta Classification and Comparison with BISAP Clinical Scoring System
Abstract Background: Untreated acute pancreatitis can have high morbidity and mortality. It is a serious gastrointestinal emergency. Its incidence is approximately 51.0 % and it can cause both local and systemic problems. The diagnosis usually involves laboratory tests like amylase and lipase as well as an ultrasound exam. The ideal imaging test is a contrast-enhanced CT scan. This study used scoring systems based on laboratory and radiological investigations to determine the clinical progression and outcome. Methods : Patients who were diagnosed with acute pancreatitis and in whom computed tomography was done were included. From the imaging findings, the category and subcategory of acute pancreatitis and types of fluid collections were described in these patients using the revised Atlanta classification. BISAP score was calculated in all these patients. The clinical outcome assessed in these patients is the duration of stay in the hospital, mortality, presence of persistent organ failure, the occurrence of infection and need for intervention. Finally, the correlation between the Revised Atlanta classification and BISAP score was analyzed and compared with clinical outcomes. Results: The analysis of the correlation between Revised Atlanta classification severity grade and BISAP score, among the n=57 patients with mild acute pancreatitis n=56, had BISAP score less than 3 and only one had BISAP score greater or equal to three. Among the n=25 patients graded as moderately severe acute pancreatitis, n=20 cases had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Among the n=08 patients graded as severe acute pancreatitis, n=3 had a BISAP score of less than 3 and n=5 had BISAP score greater than or equal to three. Conclusion: Standardizing nomenclature and facilitating proper documentation of a variety of imaging abnormalities in acute pancreatitis is made possible by incorporating the new Atlanta categorization system into daily practice. We can triage, predict, and treat patients with acute pancreatitis with greater precision by integrating the new Atlanta classification with BISAP clinical grading, significantly improving medical care.
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