100例老年急性胰腺炎临床诊治与分析

Analysis and treatment of 100 elderly cases with acute pancreatitis

本文总结１００例老年急性胰腺炎（ＡＰ）的诊治经验并与同期２５１例中青年ＡＰ对比分析。老年组死亡率１２．０％，显著高于中青年组５．２％（Ｐ＜０．０５），其原因与老年组出血坏死型（ＨＮＰ）占４１．０％，高于中青年组１５．９％有关（（Ｐ＜０．０１）。老年组术后死亡率９．３％与中青年，组８．２％相近（Ｐ＞０．０５），老年组中ＨＮＰ术后死亡率为１３．３％，明显低于保守治疗后死亡率７２．７％（Ｐ＜０．０１）。手术应安全、简捷，建议以清创术代替规则性胰腺切除术。

This paper summerized our experience in the diagnosis and treatment of acute pancreatitis (AP) in 100 elderly patients.Comparing to the young and middle aged group (251 cases),the mortality of the elder group was higher,being 12.0 and 5.20%,respectively(P< 0.05).The reason was that the percentage of hemorrhagic and necrotic pancreatitis (HNP) in the elder group(41.0%) was hihger than that in the young and middle aged group ( 15.9 %), P< 0.01. Postoperatively,the mortality of the elder group (9.3%) was similar to that of the young and middle aged group (8.2%),P >0.05.In the elder group with HNP,the mortality (13. 9%) of surgical treatment less than that of medical treatment (72. 2 %), P<0. 01. According to our experience,the surgery treatment for acute pancreatitis of the elderly should be simple-Thus pancreatic debridement should be applied in most cases instead of regular pancreatectomy.