The Applicative Value Study Of Ultrasound In Severe Acute Pancreatitis

Objective Explore the applicative value of ultrasound in diagnosing severe acute pancreatitis,judging severity and choosing operation indication.Methods Clinical data of 116 cases of severe acute pancreatitis in our hospital from Jan.2006 to Jun.2008 which were proved by clinical examination,surgical pathology were retrospective analyzed.The data included the patients' gender,age, etiology,clinical symptom,procedure of treatment,curative result.And the findings of ultrasound,CT and MRI were compared analyzed.According to ultrasound findings,everyone was given a mark based on the degree of the imaging changes and was classified into group according to their own score.Comparative study was done between the ultrasonic score and clinical data.Result In severe acute pancreatitis patients,the mean age was 56.6±11.7 years,sex ratio was 1.3:1,the number of patients from 30 to 70 years was 76(65.5%).The most common clinical symptom was abdominal pain(100%),then nausea(75%) and Vomiting(75%);The most common physical examinations was abdominal tenderness(87.9%),hypoactive bowel sounds(31.9%).The main etiological factor was biliary system disease,hyperlipidemic and alcohol.There was no statistical difference in diagnostic accurate rate for acute pancreatitis among ultrasound,CT and MRI.The diagnostic sensitivity for ascites fluid in ultrasound and MRI was higher than in CT.The diagnostic sensitivity for biliary system stone in ultrasound was higher than in CT.Mean length of hospitalization,operation number was increasing with higher ultrasonic score.Ultrasonic score related to the severity of acute pancreatitis based on≥6 score as a criterion,comparative study was done between the ultrasonic score and APACHEⅡscore.In early stage therapy progress of biliary severe acute pancreatitis,ultrasound could judge expand,stone,obstruction in CBD and choose operation style.Ultrasound-guided percutaneous catheter drainage could make the patients' situation better.Accordingto ultrasound judging infection and abscess,dynamic observing local complications change,we could correct therapy plan,provide valuable information for operation.Conclusion Severe acute pancreatitis frequently happens in people aged from 40 to 70 years old,male is more than female.The most common clinical symptom is abdominal pain,nausea and vomiting;The most common physical examinations is abdominal tenderness,hypoactive bowel sounds;There is no statistical difference in diagnostic positive rate for acute pancreatitis among ultrasound,CT and MRI.The diagnostic sensitivity for as cites fluid in ultrasound and MRI is higher than in CT. The diagnostic sensitivity for biliary system stone in ultrasound was higher than in CT.Ultrasonic score method is quick,accurate and has practical value in judging the severity of acute pancreatitis.Ultrasound can provide more accurate etiology diagnosis for biliary pancreatitis and evidence for making therapy plan.In early therapy progress of severe acute pancreatitis,ultrasound can judge obstruction in CBD and choose operation style.Ultrasound-guided percutaneous catheter drainage can make the patients' situation better.According to ultrasound judging infection and abscess,dynamic observing local complications change,we can correct therapy plan, provide valuable information for operation.Ultrasound is one of the useful methods for diagnosing severe acute pancreatitis,and has better clinical application value in treatment.