老年急性胰腺炎患者57例临床分析

Clinical analysis of elderly patients with acute pancreatitis

目的总结老年急性胰腺炎（AP）的临床特点,提高对老年急性胰腺炎的诊治水平。方法回顾性分析近4年来我院急诊科收治的57例老年（60-87岁）AP患者（观察组）的临床资料,并与同期收治的61例非老年（16-59岁）AP患者（对照组）进行对比分析。结果观察组患者呕吐,发热和腹肌紧张三个临床表现的发生率均低于对照组患者（P〈0.05）;观察组CT检查发现患者胰腺肿大和胰周积液的发生率低于对照组（P〈0.05）,而胸腹腔积液,胆囊结石和胆道扩张的发生率高于对照组（P〈0.05）;观察组患者的并发症（休克,意识障碍,MODS,酸碱失衡,电解质紊乱和消化道出血）发生率高于对照组患者（P〈0.05）。结论老年AP患者中胆道疾病的发生率较高,临床表现不典型。老年AP患者全身反应和并发症严重,死亡率高。

Objective To enhance the ability of diagnosis and treatment of acute pancreatitis （AP） by summarizing the clinical characteristics of elderly patients with this disease.Methods A retrospective analysis of clinic data of 57 elderly pa-tients with AP （60 -87 years old,observation group） was performed,which was compared with that of 61 non-elderly patients （16 -59 years old,control group） in the same period.Results Compared with the control group,the occurrence of clinical symptoms of vomiting,fever and abdominal tension in the elderly was lower（P 〈0.05）.CT examination found that the occur-rence of pancreatic swelling and effusion around pancreas in the elderly was lower than in the control group（P 〈0.05）.But the occurrence of effusion in thoracic and abdominal cavity,gallbladder stone and bile duct＇s dilatation was higher in the elderly than in the control group（P 〈0.05）.The occurrence of complications（including shock,disorder of consciousness,MODS,acid-base imbalance and electrolyte disturbances）in the elderly was higher than in the control group（P 〈0.05）.Conclusion The occurrence of biliary diseases was higher in the elderly than in the non-elderly.The clinical manifestation was atypical in the elderly.Systemic reactions and complications were serious,which can lead to high mortality.