摘要
目的探索急性胰腺炎 (AcutePancreatitis,AP)病人胰腺影像学变化与进食时间及种类的相关性。方法将临床症状、体征已消失 ,血淀粉酶及尿淀粉酶基本恢复正常的 2 0 4例AP病人随机分为对照组 99例和观察组10 5例。对照组仅根据血淀粉酶及尿淀粉酶值、胃肠功能恢复情况和病人自我感觉而决定进食时间和种类 ;观察组除根据上述因素外 ,还依据胰腺的B超及CT影像学变化决定进食时间和种类。结果进食 12 8d期间两组腹痛发生率 (对照组 2 2 .2 % ,观察组 10 .5 % )和AP反跳发生率 (对照组 18.2 % ,观察组为 0 )比较 ,差异均有显著性意义 (均P <0 .0 5 )。该研究还发现胰腺及胰周的影像学变化常常与病人临床症状、体征的变化不一致 ;BalthazarCT分级和APACHE Ⅱ记分越高 ,再进食后腹痛和AP反跳发生率就越高 (P <0 .0 5 )。
Objective To expolore the correlation of the timing and character of re feed of patients with acute pancreatitis (AP). Methods Two hundred and four cases of AP were randomly divided into control group ( n =99) and observation group ( n =105). The timing and character of re feed of the patients in the control group were determined on the basis of the blood and urine amylase levels, function of the gastrointestinal tract, and symptoms and signs of the patients. The timing and character of re feed of the patients in the observation group were determined on the basis of the imaging changes of ultrasonography and CT scan of the pancreas besides the level of the blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs of the patients. Results The recurrence rate of abdominal pain(control group:22.2%, observe group:10.5%) and the relapse rate (control group: 18.2%, observe group: 0) of both groups were different significantly ( P <0.05).It was also found that imaging changes of the pancreas and peripancreatic tissue were usually inconsistent to the symptoms and signs of AP patients, the higher the Balthazar grading and APACHE Ⅱ score were, the higher the recurrence rate of abdominal pain and the relapse rate of AP after re feed ( P <0.05). Conclusion Imaging changes of the pancreas might be served as a basis for the best occasion of re feeding light semi fluid diet and light diet in AP patients.
关键词
急性胰腺炎
胰腺影像学
进食
acute pancreatitis
pancreatic imaging
re feed
