[急性胰腺炎的预后：兰森标准还是急性生理与慢性健康状况评分系统II？]

[Prognosis of acute pancreatitis: Ranson or APACHE II?].

作者信息

Paredes Cotoré J P, Bustamante Montalvo M, Fernández Rodríguez E, Valeiras Domínguez E, Potel Lesquereux J

机构信息

Servicio de Cirugía General, Hospital General de Galicia, Facultad de Medicina, Universidad de Santiago de Compostela.

出版信息

Rev Esp Enferm Dig. 1995 Feb;87(2):121-6.

PMID:7748704

Abstract

OBJECTIVE

The aim of this paper is to determine which is the best early prognostic score in acute pancreatitis among those we have studied.

DESIGN

Prospective study of acute pancreatitis cases during a 5 year period.

PATIENTS

113 patients, biliary etiology in 93 cases, (average age: 63 years) and 66% females. The diagnostic accuracy of Ranson, Imrie, Osborne and apache II scores was analyzed.

RESULTS

There were complications in 12%, and mortality was 8%. Among all the systems analyzed the Ranson criteria achieved the highest sensitivity (79%), although sensitivity was improved with Apache II at admission to the hospital (86%). We have obtained the best specificity with the Apache II (89%) and with the Osborne criteria (88%). The modification of Ranson's criteria for biliary etiology didn't improve the sensitivity (56%) to detect severe cases of acute pancreatitis.

CONCLUSIONS

The Apache II system was the best for the early detection of severe acute pancreatitis. Its diagnostic sensitivity was higher than the multiple laboratory criteria analyzed.

摘要

目的

本文旨在确定在我们所研究的急性胰腺炎早期预后评分系统中，哪一个是最佳的。

设计

对5年期间的急性胰腺炎病例进行前瞻性研究。

患者

113例患者，93例为胆源性病因（平均年龄：63岁），女性占66%。分析了兰森（Ranson）、英瑞（Imrie）、奥斯本（Osborne）和急性生理与慢性健康状况评分系统II（apache II）评分的诊断准确性。

结果

并发症发生率为12%，死亡率为8%。在所有分析的系统中，兰森标准的敏感性最高（79%），不过入院时急性生理与慢性健康状况评分系统II的敏感性更高（86%）。急性生理与慢性健康状况评分系统II（89%）和奥斯本标准（88%）的特异性最佳。针对胆源性病因对兰森标准进行修改后，检测急性胰腺炎重症病例的敏感性并未提高（56%）。