摘要
目的探讨老年人急性胰腺炎的临床特点。方法回顾性分析本院2013年1月~2015年12月住院治疗的106例老年急性胰腺炎(acute pancreatitis,AP)患者临床资料,并与同期住院的103例非老年AP患者相对照。结果老年组男女患病率相近(男∶女=1∶1.07),非老年组男性多于女性(男∶女=2.8∶1)。老年组胆源性AP 70例,占66.0%,非老年组胆源性23例,占22.3%,差异有统计学意义(P<0.01)。老年组患者症状不典型,以腹胀、恶心、呕吐、发热、腰背酸痛为首发症状。老年组血淀粉酶的异常率(90例,84.9%)低于非老年组(99例,96.1%),差异有统计学意义(P<0.01)。老年组重症急性胰腺炎有10例(9.4%),非老年组2例(1.9%),差异有统计学意义(P<0.01)。老年组并发症发生率高,感染者占66%,非老年组占29.1%(P<0.01)。老年组多器官功能障碍占6.6%,非老年组占1%(P<0.05)。老年组死亡7例,其中80岁以上者5例,非老年组死亡1例,差异有统计学意义(P<0.05)。结论老年人AP病因以胆源性为主,且症状不典型,部分老年患者缺乏典型腹痛,而以恶心、呕吐、腹胀不适起病,应予重视。老年急性胰腺炎并发症发生率高,病情进展快,死亡风险随年龄增长而增加,尤其高龄老人。老年人急性胰腺炎的诊治应高度重视。
Objective To explore the clinical characteristics of acute pancreatitis in the elderly. Methods The clinical data of 106 elderly patients with acute pancreatitis and 103 non-elderly patients with pancreatitis in Heze Municipal Hospital from January 2013 to December 2015 were analyzed by the retrospective analysis. Results No gender difference in the incidence of AP was found in elderly patients （1：1.07）,but the incidence in men was higher than that in women in non-elderly patients（2.8：1）. In 66 percent of the elderly AP patients （70 cases）, the disease was of biliary origin; this was true of 22.3 percent of the non-elderly patients （23 cases）, representing a significant difference （P 〈 0.01）. The main causes of AP in non-elderly patients were alcohol intake,hyperlipidemia and overeating. The symptoms in 7 elderly AP patients did not include apparent abdominal pain but did include bloating,nausea/vomiting,fever and back pain. The rate of abnormal amylase levels in the elderly group was lower than that in the non-elderly group （84.9%vs 96.1%,P〈0.01）.The incidence of severe acute pancreatitis in the elderly group was higher than that in the non-elderly group （9.4% vs 1.9%,P 〈 0.01）. The concurrent infection rate was higher in the elderly group than in the non-elderly group （66% vs 29.1%,P 〈 0.01）. More patients exhibited multiple organ dysfunction in the elderly group than in the non-elderly group （6.6%vs 1%,P〈0.05）. The mortality rate was higher in the elderly group than in the non-elderly group. Biliary etiology was the main cause in the elderly AP patients. Attention should be paid to elderly AP patients because the symptoms in some patients do not include typical abdominal pain but do include nausea ,vomiting and bloating. The main features of AP in the elderly include a high incidence of complications and rapid progression of the disease ,and these patients exhibit an especially high mortality rate;therefore, we should attach great importance to the diagnosis an
作者
王娜娜
刘庆民
Wang Nana Liu Qingmin(Department of Gastroenterology Heze Municipal Hospital, Heze 274031, China)
出处
《中华保健医学杂志》
2017年第2期145-147,共3页
Chinese Journal of Health Care and Medicine
关键词
老年人
急性胰腺炎
临床特点
Senile
Acute pancreatitis
Clinical features
