Heller S J, Noordhoek E, Tenner S M, Ramagopal V, Abramowitz M, Hughes M, Banks P A
Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Pancreas. 1997 Oct;15(3):222-5. doi: 10.1097/00006676-199710000-00002.
Our objective was to determine whether pleural effusion is a predictor of severity in acute pancreatitis and, if so, whether it is an independent predictor. One hundred ninety-six consecutive cases of acute pancreatitis from October 1, 1994, to September 30, 1995, were reviewed. Medical records were analyzed for evidence of pleural effusion by chest radiograph and severe acute pancreatitis by identification of pancreatic necrosis or organ system dysfunction. Data were analyzed to determine if identification of pleural effusion provided an early sign of severity. Among 135 patients who underwent chest radiography, pleural effusion was seen in 16 of 19 (84.2%) with severe pancreatitis and 10 of 116 (8.6%) of patients with mild pancreatitis (p < 0.001). Pleural effusion was noted in severe pancreatitis prior to clinical or computed tomography evidence of severity in only 20% of cases. Pleural effusion is strongly associated with severity in acute pancreatitis but provides independent information on severity in only a minority of cases.
我们的目的是确定胸腔积液是否为急性胰腺炎严重程度的预测指标，若如此，它是否为独立预测指标。回顾了1994年10月1日至1995年9月30日期间连续收治的196例急性胰腺炎病例。通过胸部X线片分析病历以寻找胸腔积液证据，并通过识别胰腺坏死或器官系统功能障碍来判断是否为重症急性胰腺炎。分析数据以确定胸腔积液的识别是否能提供严重程度的早期迹象。在135例行胸部X线检查的患者中，19例重症胰腺炎患者中有16例（84.2%）出现胸腔积液，116例轻症胰腺炎患者中有10例（8.6%）出现胸腔积液（p<0.001）。在仅20%的病例中，重症胰腺炎患者在临床或计算机断层扫描显示严重程度之前就已发现胸腔积液。胸腔积液与急性胰腺炎的严重程度密切相关，但仅在少数病例中提供关于严重程度的独立信息。
