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急性胰腺炎(AP)是临床上常见的急腹症,由多种原因导致胰酶激活,引起胰腺局部及全身病变;分为轻型急性胰腺炎(MAP)和重症急性胰腺炎(SAP)。由于全身炎症反应综合征(SIRS)和多器官功能衰竭(MOF)导致重症急性胰腺炎发生。AP的总病死率约为2%~5%,但SAP起病急、病情凶险、治疗困难、病死率高(20%~30%)[1]。AP发病机制复杂,病程变化大,故早期对AP的严重性和预后评价可有助于控制疾病的进展,提高治疗率,降低病死率。但目前尚无统一确切的评价标准被临床医生广泛运用。作者现将目前临床工作中常用的几类AP严重性及预后评价方法综述如下。1多因素评价标准1.1 Ranson评分标准该评分标准包含患者入院时及48h
Acute pancreatitis (AP) is a common clinical acute abdomen, pancreatic enzyme activation caused by a variety of reasons, causing pancreatic local and systemic disease; divided into mild acute pancreatitis (MAP) and severe acute pancreatitis (SAP). Severe acute pancreatitis occurs due to systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF). The overall mortality rate of AP is about 2% ~ 5%, but SAP is in acute onset, dangerous condition, difficult to treat and high mortality (20% -30%) [1]. The pathogenesis of AP is complex and its course varies greatly. Therefore, the early evaluation of the severity and prognosis of AP may help to control the progress of the disease, improve the treatment rate and reduce the mortality rate. However, there is no uniform and accurate evaluation standard widely used by clinicians. The authors now summarize several types of AP severity and prognostic evaluation commonly used in clinical practice. A multi-factor evaluation criteria 1.1 Ranson score standard The score criteria include admission and 48h