摘要
目的探讨老年重症急性胰腺炎患者的临床特点及预后影响因素。方法回顾性分析2010年4月~2014年10月入住笔者医院的46例老年重症急性胰腺炎患者的临床资料,总结其临床特点,采用单因素分析及多因素逐步Logistic回归,分析其死亡相关因素。结果 46例老年重症急性胰腺炎患者中,男性25例(54.35%),女性21例(45.65%),患者年龄72.02±8.70岁,器官衰竭数目(1.5,2)个。最常见的病因是胆源性(61.7%,29/46),腹痛(84.78%,39/46)是最主要的就诊症状,高血压病(69.57%,32/46)是最常见的基础疾病,肺(45.65%,21/46)和肾(47.83%,22/46)是最容易发生衰竭的器官;总病死率41.30%(19/46)。多因素逐步Logistic回归分析显示,血氧分压降低和器官衰竭数目≥2是老年重症胰腺炎患者死亡的独立危险因素。结论老年重症急性胰腺炎患者并发症多,预后差,病死率高。当出现血氧分压降低或发生器官功能障碍的数目≥2时提示患者预后不良,应予以充分重视及时采取有效治疗。
Objective To investigate the clinical characteristics and prognostic factors of severe acute pancreatitis （SAP） in elderly patients （ I〉60 years of age）. Methods The clinical data of 46 patients with SAP in First Affiliated Hospital of Wenzhou Medical Uni- versity from April 2010 to October 2014 were studied retrospectively to summarize its clinical characteristics. Single and multivariate Logis- tic regression analysis were employed to analyze the risk factors associated with mortality. Results There were 25 males and 2 females with a mean age of 72.02 ± 8.70 years old. The mean number of organ failure was （1.5,2）. Biliary etiology （61.7%） was the first cause. Abdominal pain （84.78%） was the main clinical symptom. The hypertension （69.57%） was the most common basic disease. Lung （45.65% , 21/46） and Kidney （47.83% , 22/46） were the organs that most likely to be failed. The overall mortality was 41.30% （19/46）. In stepwise logistic regression analysis, the number of failed organ and the decreased of blood oxygen partial pressure were the risk factor associated with death. Conclusion The elderly patients with SAP have high proportion of complication, poor prognosis and high mortality. It must be seriously treated. Timely and effective measures should be adopted when the patient has decreased of blood oxy- gem partial pressure or more than two numbers of failed organ.
出处
《医学研究杂志》
2017年第1期84-87,共4页
Journal of Medical Research
基金
浙江省中医药重点学科计划项目(2012-XK-A28)
浙江省"十二五"重点学科建设项目(2012-207)
浙江省医学创新学科建设项目(11-CX26)
关键词
老年
重症急性胰腺炎
临床特点
预后
Elderly
Severe acute pancreatitis
Clinical characteristics
Prognostic factor
