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目的分析急性胰腺炎（ＡＰ）的预后因素．方法ＡＰ患者１７８例，男７６例，女１０２例，年龄１７岁～８５岁，平均５３６岁±１６岁，其中水肿型１２０例，坏死型５８例．分别以Ｒａｎｓｏｎ标准和ＢａｎｋＷｉｓｅ标准作为判断轻症和重症的标准．ＣＴ和（或）Ｂ超对ＡＰ的诊断采用Ｂａｌｔｈａｚａｒ分级法．结果Ｒａｎｓｏｎ标准５项以下者（轻症）１４９例，死亡率为６０４％，６项以上者（重症）２９例，死亡率为６５５０％．ＢａｎｋＷｉｓｅ标准阴性者（轻症）１４４例，死亡率为４１７％．１项以上阳性者（重症）３４例，死亡率为６４７０％．预测轻症和重症的死亡率这两种标准间差异无显著性（Ｐ＞００５）．年龄、胰腺坏死程度、并发症等对ＡＰ预后有显著的影响（Ｐ＜００１）．ＣＴ和（或）Ｂ超诊断急性坏死型胰腺炎（ＡＮＰ）的敏感度为７０７％，特异度为１００％．结论Ｒａｎｓｏｎ标准应结合ＢａｎｋＷｉｓｅ标准，综合考虑胰腺坏死程度，并发症等对ＡＰ预后的影响．ＣＴ、Ｂ超等影象学诊断对于判断胰腺坏死程度有一定的参考价值．
Objective To analyze the prognostic factors of acute pancreatitis (AP). Methods A total of 178 AP patients, 76 males and 102 females, ranging in age from 17 to 85 years, with an average age of 53.6 years and 16 years, of which 120 were edematous and 58 were necrotic. Respectively to Ranson standard and Bank Wise standard as a judge of mild and severe criteria. Balthazar classification was used for the diagnosis of AP with CT and / or B-ultrasound. Results There were 149 cases with less than 5 items of Ranson standard (mild), with a mortality rate of 6.04% and 29 patients with more than 6 items (severe type) with a mortality rate of 6550%. There were 144 cases of Bank-Wise standard negative (mild) with a mortality rate of 4.17%. One or more positive (severe) 34 cases, the mortality rate was 64 70%. There was no significant difference between the two standards in predicting mild and severe mortality (P> 005). Age, the degree of pancreatic necrosis and complications have a significant impact on AP prognosis (P <001). The sensitivity and specificity of CT and / or B-ultrasound in diagnosis of acute necrotizing pancreatitis (ANP) were 70.7% and 100% respectively. Conclusion Ranson criteria should be combined with Bank-Wise criteria, considering the degree of pancreatic necrosis, complications and other effects on AP prognosis. CT, B ultrasound imaging diagnosis for determining the extent of pancreatic necrosis have a certain reference value.