老年人急性胰腺炎临床特点分析

Clinical Analysis of Senile Acute Pancreatitis

目的探讨老年人急性胰腺炎（acute pancreatitis，AP）的临床特点、诊治措施及影响预后的因素。方法对75例老年人急性胰腺炎进行回顾性分析，并与同期非老年病人78例作比较。结果两组AP的病因情况比较，老年组占首位的为胆源性，其次为高脂血症，非老年组占首位的为酒精性，其次为胆源性，两组比较有非常显著的统计学意义（P〈0．01）。并发症老年组高达68．0％，非老年组为39．7％（P〈0．01）。多器官功能障碍综合征（MODS）发生率老年组24．0％，非老年组10．3％（P〈0．05）。两组治愈率、缓解率及病死率均具有统计学差异（P〈0．05）。结论老年人急性胰腺炎具有临床表现不典型、病情重、以胆源性疾病为主要病因、并发症多的特点，应采取综合治疗措施，以降低病死率，改善预后。

Objective To explore the clinical features and treatmentmeasures of senile acute pancreatitis and factors that influence the prognosis. Methods Retrospective analysis was made on the clinical data of 75 cases of senile acute pancreatitis; comparison was made with 78 cases of non - senile acute pancreatitis. Results Biliogenic pancreatitis was the primary etiology of acute pancreatitis in the senile group and hyperlipemia was insecondary; alcoholic pancreatitis was the primary etiology in the non-senile group but biliogenic was insecondary; the difference of 2 group was significant （P〈0.01）. 51 cases （68.0%） in the senile group and 31 cases （39.7%） in the non-senile group experienced complications, the difference was significant （P〈0.01）; incidence of MOS in the senile group was 24.0%, that in non-senile group was 10.3% （P〈0.05）. Cure rate, remission rate and case fatality of 2 group were obviously different （P〈0.05）. Conclusions The cliniealmanifestations of senile acute pancreatitis are nontypical, biliogenie pancreatitis was the primary etiology and severe with many complications; active comprehensive treatment can degrade case fatality and improve the prognosis of the patients.