老年人急性胰腺炎122例临床分析

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122例，并与同期非老年患者（非老年组）120例作比较。结果 老年组的诱因主要为胆结石症（81例，66．3％），主要临床表现为腹痛、发热，其中2例因腹痛症状轻微，血淀粉酶升高不明显而漏诊，尸检证实为急性胰腺坏死。其中重症胰腺炎45例，老年组31例，非老年组14例，老年组重症胰腺炎突出表现为呼吸功能不全22例（70．9％），休克7例（22．5％），肾功能不全5例（16．1％）。并存症，老年组36例，非老年组10例，两组比较差异有统计学意义（P〈0．01），主要为心、脑、肺疾病及糖尿病。老年组死亡6例，病死率为4．9％，死因主要为休克；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 122 elderly cases of acute pancreatitis

Objective To investigate the clinical features and prognosis of elderly patients with acute panereatitis.Methods One hundred and twelve elderly patients with acute pancreatitis were included in our study.The clinical features and prognosis were compared with those of the 120 non -aged patients with acute pancreatitis during the same period.Results Cholecystolithiasis was the most common etiology of acute pancreatitis in both groups81 cases(66.3%) in aged group,70 cases (58.3%) in non-aged group].Abdominal pain was the most common symptom in both groups, followed by fever.Two elderly cases were diagnosed only by autopsy because of mild abdominal pain and rapidly attack of shock.There were 31 cases with severe pancreatitis in aged group and 14 in non -aged group (P<0.01).Respiratory failure was the most common organ failure (22 cases in aged group and 5 cases in non-aged group),followed by shock (7 cases in aged group and 1 cases in non -aged group) and renal failure.Mortality rate was significantly higher in aged group (4.9%) with 4 cases dying of shock,1 case dying of respiratory failure and 1 case dying of renal failure.No dead patient was found in the non-aged group.Conclusions Symptoms of acute pancreatitis in elderly patients were atypical.Respiratory failure and shock are common in aged group.Severe pancreatitis and its mortality rate are significantly higher in elderly patients.