【摘要】 目的 探究CT严重指数（CTSI）与急性生理和慢性健康评分（APACHEⅡ评分）对急性胰腺炎（AP）患者预后的评估效能。方法 回顾性分析我院2021年1月-12月收治的273例AP患者，观察其腹部增强CT图像，根据CT表现分为水肿性AP和坏死性AP，并根据其图像进行CTSI评分。在入院后24 h内计算APACHEⅡ评分、局部并发症、死亡、住院时间及入住ICU天数。分析CTSI、APACHEⅡ评分分别与局部并发症、死亡、住院时间及入住ICU天数的关系。结果 在AP患者中，发生局部并发症的患者CTSI评分高于无局部并发症的患者（P<0.05）；有、无局部并发症患者的APACHEⅡ评分比较，差异无统计学意义（P>0.05）；死亡患者APACHEⅡ评分高于存活患者（P<0.05）；死亡与存活患者的CTSI评分比较，差异无统计学意义（P>0.05）；在预测住院天数方面，CTSI评分及APACHEⅡ评分越高，住院时间越久（r=0.340、0.264）。需要转入ICU患者的CTSI评分及APACHEⅡ评分均高于不需要转入ICU的患者（P<0.05）。结论 在急性胰腺炎患者中，CTSI评分在评估局部并发症方面优于APACHEⅡ评分，但在评价死亡方面不如APACHEⅡ评分；CTSI及APACHEⅡ评分均能预测患者住院天数和是否转入ICU。更多还原

【Abstract】 Objective To study the computed tomography severity index(CTSI) and the acute physiology and chronic healthy evaluation Ⅱ(APACHEⅡ) on the prognosis of patients with acute pancreatitis(AP).Methods A retrospective analysis of 273 AP patients admitted to our hospital from January to December 2021 was performed to observe their abdominal enhanced CT images. According to CT findings, they were divided into edematous AP and necrotic AP, and CTSI scores were performed according to their images. APACHE Ⅱ score, local complications, death,hospitalization time and ICU stay were calculated within 24 hours after admission. The relationship between CTSI, APACHE Ⅱ score and local complications, death, hospitalization time and ICU stay was analyzed.Results In AP patients, the CTSI score of patients with local complications was higher than that of patients without local complications(P<0.05). There was no significant difference in APACHEⅡ score between patients with and without local complications(P>0.05). The APACHEⅡ score of the dead patients was higher than that of the survival patients(P<0.05), while, there was no significant difference in CTSI score between dead and surviving patients(P>0.05). In terms of predicting hospitalization days, the higher the CTSI score and APACHEⅡ score, the longer the hospitalization time(r=0.340, 0.264). The CTSI score and APACHEⅡ score of patients who needed to be transferred to ICU were higher than those of patients who did not need to be transferred to ICU( P<0.05).Conclusion In patients with acute pancreatitis, CTSI score is superior to APACHEⅡ score in evaluating local complications, but inferior to APACHE Ⅱ score in evaluating death. Both CTSI and APACHEⅡ scores can predict the length of hospital stay and whether patients are transferred to ICU.更多还原