赵汝莲　高娜

[摘要] 目的 探讨CT在急性胰腺炎中的临床价值。 方法 选择2016年1月～2017年1月间我院住院接受治疗的38例急性胰腺炎患者，排除存在严重心脑肾疾病、休克、精神疾病者，采用德国 SIEMENS 公司生产的64排螺旋CT进行检查。 结果 38例AP患者中，水肿型30例，腺体体积明显增大，腺体密度欠均匀，局部边缘模糊，与周围脂肪层界限不清，增强扫描后未见坏死区域。急性坏死型胰腺炎8例：CT显示胰腺密度不均匀、體积明显增大、斑片状或大片状低密度灶特点，其中出血3例，坏死脓肿2例，其中部分坏死假囊肿或脓肿于动脉期肝脏一过性区域行强化特点。并发症：胰腺周围脓肿12例、假性囊肿8例、少量胸腔积液3例。 结论 CT检查不仅可以判定急性胰腺炎的类型，还可以了解病变的进展情况，为临床治疗提供可靠的依据，是目前诊断急性胰腺炎较有效可靠的检查方法。

[关键词] 急性胰腺炎；CT；急性坏死型胰腺炎；诊断价值

[中图分类号] R576 [文献标识码] B [文章编号] 1673-9701（2017）24-0097-02

[Abstract] Objective To explore the clinical value of CT in acute pancreatitis（AP）. Methods A total of 38 patients with acute pancreatitis who were hospitalized in our hospital from January 2016 to January 2017 were selected. The patients with serious heart diseases， brain and kidney diseases， shock and mental illness were excluded. 64-slice spiral CT manufactured by SIEMENS， Germany was applied. Results Of the 38 patients with AP， 30 cases were with edema. Gland volume was increased significantly， with less uniform gland density. Local margin was blurred， with unclear boundary with the surrounding fat layer. No necrosis area was observed after enhanced scan. Acute necrotizing pancreatitis in 8 cases： CT showed uneven density of pancreas， and the volume was significantly increased， with the characteristics of patchy or large flaky low density lesions. There were 3 cases of bleeding and 2 cases of necrotic abscess. Some of these necrotic pseudocyst or abscesses had the enhanced characteristics in the liver transient area during the arterial phase. Complications： abscess around the pancreas in 12 cases， pseudocyst in 8 cases， a small amount of pleural effusion in 3 cases. Conclusion CT examination can not only determine the type of acute pancreatitis， but also can understand the progress of the disease， so as to provide a reliable basis for clinical treatment， which is an effective and reliable examination method in the diagnosis of acute pancreatitis.

[Key words] Acute pancreatitis； CT； Acute necrotizing pancreatitis； Diagnostic value

急性胰腺炎（acute pancreatitis，AP）是胰腺的急性炎症，常累及邻近组织和远处器官[1]。急性胰腺炎为常见的急腹症，发病急、并发症多，若治疗不及时，则会产生严重的后果。血尿淀粉酶为常用的实验室检查方法，但不能反映病情的严重程度，常规 B 超也为常用检查方法，但易受胃肠道积气的影响判断结果[2]。CT为急性胰腺炎确诊的重要手段，其在判断疾病严重程度及预后、治疗方式的选择方面具有重要作用[3，4]。本研究旨在探讨CT诊断急性胰腺炎的临床价值。……