老年急性胰腺炎患者临床特征分析

Clinical characteristics of acute pancreatitis in elderly patients

目的 探讨老年急性胰腺炎患者的临床特点。 方法 回顾性分析我院 1993～ 1999年间住院的老年急性胰腺炎患者病历资料 ,分别统计发病诱因、临床症状、检查和治疗结果。 结果83例患者共发病 10 7次 ,其中轻型急性胰腺炎 80例次 ,重症Ⅰ级 2 3例次 ,重症Ⅱ级 4例次 ;以腹痛为首发症状的占 94 4% (10 1/10 7) ,以其他症状为首发表现的占 5 6 % (6 /10 7) ;有胆系结石患者占5 3 0 % (44例 ) ,仅有胆囊炎而无明确胆系结石患者占 7 2 % (6例 ) ,发病前有进食高脂饮食史者占2 6 5 % (2 2例 ) ,13例急性胰腺炎反复发作的患者中 11例有胆系结石 ;腹部B超和CT检查的阳性诊断率分别为 6 0 5 %和 72 6 % ,两者有良好的一致性。 结论 老年急性胰腺炎患者症状表现不典型 ;胆系疾患包括不易被发现的胆系泥沙样结石是其常见的致病原因 ,尤其是急性复发性胰腺炎的重要原因 ,高脂饮食或进食过饱是常见的诱因 ;B超和CT检查是诊断急性胰腺炎的良好辅助手段。

Objective To study the clinical features of acute pancreatitis (AP) in elderly patients. Methods The elderly AP patients from January 1993 to October 1999 in our hospital were studied retrospectively. Results There are 83 cases with a male to female ratio of 1 5∶1 and a median age of 72 7 years.AP was diagnosed in 83 cases for 107 times which included 80 times of mild AP and 27 times of severe AP 13 patien with APts were diagnosed for more than one times.Abdominal pain was the primary symptom in 94 4% patients. 6 patients had no pain 53 0%(44/83) and 84 6%(11/13) patients had cholelithiasis and recurrent AP respectively.60 5% and 72 6% patients were diagnosed by type B ultrasonic and CT respectively . Conclusions In elderly AP patients,abdominal pain was the primary symptom, but a part of patients had no typical symptoms.Cholelithiasis including biliary sludge was an inducement especially in recurrent AP patients. Type B ultrasonic and CT examination were important means in diagnosis.