老年重症急性胰腺炎25例临床分析

目的总结老年人重症急性胰腺炎（severe acute pancreatitis，SAP）的临床诊治特点，以提高对老年人重症急性胰腺炎的认识。方法回顾性分析近5年来收治25例老年（60～84岁）SAP患者的例临床资料，并与同期30例非老年人（22—59岁）对照组SAP患者资料进行对比研究。结果老年SAP患者以胆石症为主要病因，多伴其他慢性疾病，老年患者各种临床症状发生率均低于对照组（P〈0．05）；老年组APACHEⅡ（24、48h）和Ranson评分高于对照组（P〈0．05）；老年患者的局部并发症和多器官功能障碍（衰竭）发生率明显高于对照组（P〈0．05）；病死率和死亡原因与对照组无明显差异。结论我国老年SAP病因以胆源性为主，临床症状无特异性，伴发疾病多，并发症和多器官功能障碍（衰竭）发生率较高。老年人急性胰腺炎仍以内科非手术综合治疗为主。

Clinical analysis of 25 elderly patients with Severe Acute Pancreatitis

Objective To summarize the characteristics of clinical diagnosis and treatment of elderly patients with severe acute pancreatitis(SAP).Methods Clinical data of 25 elderly patients(60-84 years old) with SAP in the past 5 years were retrospectively analyzed,and comparison between elderly patients and 30 non-elderly SAP patients(22-59 years old) in the same period was made.Results Cholelithiasis was the major etiology of SAP in elderly patients who also accompanied.Compared with the control group,the occurrence of clinical symptoms in the elderly group was lower(P < 0.05),the scores of APACHE II(24 h,48 h) and Ranson in the elderly group were higher(P < 0.05),but the occurrence of local complications and multiple organ dysfunctions(failure) in the elderly group was significantly higher(P < 0.05);there was no significant difference in mortality and causes of death between the two groups.Conclusion The cause of SAP in elderly patients was mainly biliary diseases。There was no specific clinical symptoms,but with many concomitant diseases and a higher incidence of complications.Non-surgical treatment was more appropriate for the elderly patients with SAP.