摘要
目的探讨老年急性胰腺炎(AP)患者的临床特征和诊疗效果。方法回顾性分析2014年1月至2016年12月首都医科大学附属北京世纪坛医院收治的老年AP患者,按年龄分为老年组[≥60岁,(68.8±6.9)岁]102例和非老年组[<60岁,(46.7±4.4)岁]213例,收集患者一般资料、病因、临床表现、治疗后住院时间及死亡率。采用SPSS 20.0软件对数据进行统计分析,根据数据类型,采用t检验或χ~2检验进行组间比较。结果两组患者性别、全身并发症、局部并发症比例及重症胰腺炎比例差异均无统计学意义(P>0.05)。AP患者主要病因为胆道疾病,其次为高脂血症,酒精及肿瘤,其中老年组胆源性比率明显高于非老年组(70.6%vs 49.8%),高脂血症比率明显低于非老年组(11.8%vs 20.2%),酒精性比率明显低于非老年组(6.9%vs 19.2%),肿瘤性比例明显高于非老年组(4.9%vs 0.0%),差异均有统计学意义(P<0.05)。临床表现方面,老年组腹痛比例显著低于非老年组(84.4%vs 95.4%),黄疸比例高于非老年组(66.7%vs 48.4%),差异均有统计学意义(P<0.05)。治疗后,两组住院时间差异无统计学意义[(12.9±5.6)vs(11.7±4.6)d,P>0.05],但老年组死亡率明显高于非老年组(7.9%vs 1.4%,P<0.05)。结论老年AP患者合并基础疾病多,病死率高。老年AP患者应警惕胆源性及肿瘤性原因。
ObjectiveTo investigate the clinical characteristics and diagnostic and treatment efficiency of acute pancreatitis(AP)for the elderly in recent years.MethodsA retrospective analysis was performed on102elderly AP patients[≥60years,(68.8±6.9)years,the aged group]admitted to our hospital from January2014to December2016.Another213AP patients[<60years,(46.7±4.4)years,the non aged group]hospitalized in the same period served as controls.The causes of disease,ratio of severe AP,clinical manifestations,systematic and local complications,length of hospital stay after treatment,and mortality rate were collected and compared between the2groups.SPSS statistics20.0was used to perform the statistical analysis.Student’s t test or Chi square test was employed for different data types.ResultsThere were no differences in the ratios of systematic complications,local complications and severe AP between the2groups(P>0.05).The leading cause of AP was biliary tract disease,followed by hyperlipidemia,alcoholic cause and tumor,and the aged group had obviously higher ratios of biliary tract disease(70.6%vs49.8%)and tumor(49%vs0.0%),but lower ratio of hyperlipidemia(11.8%vs20.2%)and alcoholic cause(6.9%vs19.2%)when compared with the control group(all P<0.05).In clinical manifestations,the incidence of abdominal pain(84.4%vs95.4%)was notably lower,while that of jaundice(66.7%vs48.4%)was remarkably higher in the aged group than the non aged group(P<0.05).There was no significant difference in the length of hospitalization time[(12.9±5.6)vs(11.7±4.6)d,P>0.05],but the mortality rate was significantly higher in the aged group(7.9%vs1.4%,P<0.05).ConclusionThe elderly AP patients have many basic diseases,and thus have high mortality rate.Clinicians should be cautious about biliary tract diseases and tumor for these patients.
作者
台卫平
张能维
朱斌
高宏
陈炜
刘红
王沧海
宿慧
刘揆亮
吴静
TAI Wei-Ping;ZHANG Neng-Wei;ZHU Bin;GAO Hong;CHEN Wei;LIU Hong;WANG Cang-Hai;SU Hui;LIU Kui-Liang;WU Jing(Department of Gastroenterology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;First Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;Second Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;Intensive Care Unit, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China)
出处
《中华老年多器官疾病杂志》
2018年第1期57-60,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
