110-2-醫學三-22腸胃內科
關於急性胰臟炎的嚴重度評估,可包括三大類,如risk factors for severity、markers of severity at admission orwithin 24 hours及markers of severity during hospitalization,下列敘述何者正確?
A與嚴重程度相關的因子(risk factors for severity)包括有年齡>60歲、BMI<30 kg/m²、具有comorbid diseases
Bmarkers of severity at admission or within 24 hours之中包括有hemodilution(hematocrit<40%)
Cmarkers of severity at admission or within 24 hours之中包括有core temperature<36度或>38度、heart rate>90beats/min
Dmarkers of severity during hospitalization包括有elevated C-reactive protein(CRP)及elevated blood sugar
核心考點
急性胰臟炎嚴重度評估分為三類(依 ACG 指引架構,數值切點各版本略有出入,以選項方向判斷即可):
- 病人風險因子:高齡(常引用 >55 歲)、肥胖(BMI >30)、合併症
- 入院/24 小時內指標:SIRS(體溫 <36 或 >38 度、心跳 >90 次/分、呼吸 >20 次/分、WBC <4000 或 >12000)、BUN >20 mg/dL、Hct >44%(血液濃縮)
- 住院期間指標:持續性 SIRS/器官衰竭、胰臟壞死、BUN 持續上升等