老年人急性胰腺炎临床分析

目的探讨老年人急性胰腺炎的临床特点、诊治措施及影响预后的因素。方法回顾性分析老年人急性胰腺炎(老年组)的临床资料31例,并与同期非老年患者(非老年组)53例作比较。结果老年组的诱因主要为胆结石症(20例占62.5%),主要临床表现为腹痛、发热,其中1例因休克入院,血淀粉酶升高,诊断为急性出血坏死性胰腺炎,抢救无效死亡。重症胰腺炎8例,老年组5例,非老年组3例,老年组重症胰腺炎突出表现为呼吸功能不全3例(60%),休克1例(20%),肾功能不全1例(20%)。并存症,老年组17例,非老年组5例,2组比较,差异有统计学意义(P<0·01)。主要并存症为心、脑、肺疾病及糖尿病。老年组死亡1例,病死率为3.2%,非老年组无死亡。结论老年人急性胰腺炎具有临床表现不典型、病情重、并存症多的特点,积极内科综合治疗,能改善患者预后。

Clinical Analysis of Senile Acute Pancreatitis

[Objective] To explore the clinical features and treatment measures of senile acute pancreatitis and factors that influence the prognosis.[Methods]Retrospective analysis was made on the clinical data of 31 cases of senile acute pancreatitis;comparison was made with that of non-senile acute pancreatitis.[Results]Cholecystolithiasis was the most common etiology of acute pancreatitis in the senile group(62.5%);abdominal pain and fever were the most common symptoms;5 cases in the senile group and 3 in the non-senile group were severe pancreatitis;the major manifestation of the severe senile pancreatitis were respiratory failure(3 cases;60%),shock(1 case;20%) and renal failure(1 case;20%);17 cases in the senile group and 5 cases in the non-senile group experienced complications,the difference was significant(P<0.01);the main complications were cardio,cerebral and pulmonary diseases and diabetes.One case of the senile group died with a mortality of 3.2%,no case died in the non-senile group.[Conclusion ]The clinical manifestations of senile acute pancreatitis are nontypical and severe with many complications;active comprehensive internal treatment can improve the prognosis of the patients.