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急性胰腺炎的CT診斷

目的 探討CT對急性胰腺炎的診斷價值。 方法 回顧性分析2007年3月-2009年10月收治的35例急性胰腺炎患者的CT照片。 結果 35例患者中CT診斷為急性水腫型胰腺炎26例(74.3%)，急性壞死型胰腺炎9例(25.7%)。CT主要表現胰腺體積增大31例，其中胰頭增大10例，胰體、尾單獨或同時增大21例，4例胰腺表現基本正常。單側或雙側腎前筋膜水腫增厚27例(77.1%)， 胰腺邊緣模糊、部分脂肪層消失20例(57.1%)，膽囊增大膽總管擴張17例(48.6%)，胰周蜂窩組織炎6例(17.1%)，合并左側胸腔積液5例(14.3%)，伴有少量腹水2例(5.7%)。 結論 CT檢查可以顯示胰腺自身腫大、壞死、出血，還能夠顯示胰外的腹腔、腹膜后腔以及腎筋膜的受累情況，可為臨床制定合理的治療方案并作出預后的判斷提供依據。

經內鏡逆行胰膽管造影術后胰腺炎預防進展

經內鏡逆行胰膽管造影（endoscopic retrograde cholangilpancreatography，ERCP）應用于臨床已有 40 余年，該微創內鏡介入技術的優點是將診斷和治療完美融于一體，隨著 ERCP 技術及設備的不斷發展，該技術已成為目前診斷和治療胰膽管疾病的重要手段之一。與此同時，ERCP 術后并發癥的發生以及如何有效防治也日益受到重視。其中 ERCP 術后胰腺炎（post-ERCP pancreatitis，PEP）是最常見的并發癥，該文就 PEP 的預防進展進行了綜述。

急性胰腺炎視網膜病變(附一例報告)

報告1例急性胰腺炎患者,患病10天后雙眼視力明顯減退,眼底后極部視網膜水腫、動脈細,有多數融合的棉絮狀斑,并散在少數出血斑.眼底熒光血管造影后發現視網膜小動脈有阻塞.復習急性胰腺炎視網膜病變的文獻,并結合病例進行簡要討論. （中華眼底病雜志，1993，9：176-177）

106例重癥急性胰腺炎臨床治療分析

慢性胰腺炎并高密度胰腺假性囊腫一例

17例重癥胰腺炎并發成人呼吸窘迫綜合征診治體會

地中海貧血并發膽源性急性胰腺炎一例

The correlation between bladder pressure and diaphragm excursion in patients with severe acute pancreatitis combined with acute respiratory distress syndrome and its predictive value for weaning outcomes

Objective Exploring the correlation between intravesical pressure (IP) and diaphragm excursion (DE) in patients with severe acute pancreatitis (SAP) and acute respiratory distress syndrome (ARDS), and evaluating its predictive value for weaning outcomes. Methods A retrospective analysis was conducted on the clinical data of 144 SAP patients with ARDS admitted between 2020 and 2023. By collecting the outcome of weaning, collect data on gender, age, acute physiology and chronic health score II (APACHE II), oxygenation index, and IP and DE before weaning and extubation for all patients. Based on weaning outcomes, divide patients into successful and failed groups, and compare the differences in various indicators between the two groups; Use binary logistic regression to analyze whether IP and DE are risk factors affecting weaning in SAP patients with ARDS, and use Pearson correlation analysis to examine the correlation between IP and DE; Use receiver operating characteristic curve (ROC curve) to analyze the predictive value of IP and DE on weaning outcomes in SAP patients with ARDS. ResultsA total of 144 SAP patients with ARDS were included, of which 108 were successfully weaned and 36 were unsuccessful. There were no statistically significant differences in gender, age, and APACHE II scores between the successful and failed groups (males: 62.96% (68/108) compared to 69.44% (25/36), age (years): 41.91 ± 8.14 compared to 42.42 ± 6.22, APACHE II score (points): 18.28 ± 2.22 compared to 18.97 ± 1.83, P>0.05). The IP of the successful group was significantly lower than that of the failed group, and the DE was significantly higher than that of the failed group [IP (mmHg): 18.45 ± 3.76 compared to 23.92 ± 5.65, DE (mm): 16.18 ± 4.23 compared to 12.28 ± 4.44, all P<0.05]. All patients showed a significant negative correlation between IP and DE (r=–0.457, P<0.001). ROC curve analysis showed that the area under the curve (AUC) of IP predicting the withdrawal outcome of SAP patients with ARDS was 0.805, with a 95% confidence interval (95%CI) of 0.724-0.885 and P<0.001. When the cutoff value was 19.5 mmHg, the sensitivity was 91.57% and the specificity was 47.54%; The AUC for predicting the withdrawal outcome of SAP patients with ARDS by DE was 0.738, with a 95%CI of 0.641-0.834 and P<0.001. When the cutoff value was 11.5 points, the sensitivity was 84.82% and the specificity was 59.38%. Conclusions There is a significant negative correlation between IP and DE in SAP combined with ARDS patients, and both have certain predictive value for weaning outcomes.

急性胰腺炎患者胃管留置中發生心搏驟停一例

重癥急性胰腺炎23例治療體會