修改过的马歇尔评分:急性胰腺炎的未充分利用的预测工具
Charles Her Yi Ling1, Richard Bond1, Simon East1
1General Surgery, York and Scarborough Teaching Hospitals NHS Foundation Trust, Scarborough, GBR.
Cureus
|December 8, 2025
概括
对急性胰腺炎的修改过的马歇尔 (MM) 评分在英国的临床实践中未得到充分利用. 简化MM得分提高了其使用,显示了其在识别不太可能需要重症监护的患者中的价值.
科学领域:
- 胃肠病学和肝病学
- 手术重症监护手术重症监护
背景情况:
- 急性胰腺炎 (AP) 是死亡的重要原因,器官衰竭使20%的病例复杂化.
- 早期风险分层对于管理AP和预防系统性损伤至关重要.
- 修改过的马歇尔 (MM) 评分是评估AP中器官功能障碍的标准工具.
研究的目的:
- 评估在急性胰腺炎患者中使用MM得分的效果.
- 确定其在临床实践中使用不足的原因.
- 评估MM评分在风险分层和预测患者结果方面的有效性.
主要方法:
- 在两年内对127名AP患者进行了回顾性审查.
- 分析电子记录,核准函和交付表.
- 对临床医生进行的关于MM得分未充分利用的问卷调查.
- 使用MM得分,格拉斯哥-伊姆里得分和CT严重程度指数进行回顾性风险分层.
主要成果:
- 只有18.9%的患者记录了MM得分.
- 低利用的主要原因包括不熟悉性,复杂性和工作量.
- 简化的MM评分和指导改善了利用率 (7/10患者).
- 低MM分数 (<2) 准确预测不需要ITU或手术 (95.8%的患者).
结论:
- 修改过的马歇尔评分在当前的临床实践中未得到充分利用.
- 尽管使用率不足,但MM评分是风险分层的可靠工具.
- 该MM得分具有很高的负预测值,帮助学员识别不需要重症监护的患者.
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