摘要
[目的]探讨老年急性胰腺炎(acute pancreatitis,AP)临床特征和预后。[方法]回顾性分析439例AP患者的临床资料,参照美国亚特兰大(Atlanta)2012最新AP标准评估病因学诊断、严重程度分级、局部并发症和器官功能衰竭,统计患者住院时间和疾病相关死亡情况。[结果]年龄≥65岁的AP患者(老年组,164例)占37.4%,年龄<65岁的AP患者(中青年组,275例)占62.6%。与中青年组比较,老年组病因为胆石症的比例高,重度急性胰腺炎(severe acute pancreatitis,SAP)所占比例高,感染性胰腺坏死(infected pancreatic necrosis,IPN)和持续性(>48 h)器官衰竭发生率高,住院时间长,病死率高,差异均具有统计学意义(P<0.05)。2组急性胰周液体积聚、急性坏死物积聚、包裹性坏死、胰腺假性囊肿和一过性(≤48 h)器官衰竭的发生率比较差异无统计学意义(P>0.05)。[结论]老年AP更容易发生IPN和持续性器官衰竭,SAP所占比例高,预后较中青年AP差。
[Objective]To investigate the clinical features and prognosis of elderly patients with acute pancreatitis(AP).[Methods]The clinical data of 439 AP patients were retrospectively analyzed.The etiological diagnosis,severity classification,local complications and organ failure were classified according to the latest AP standards of Atlanta 2012,and the length of stay and mortality were documented.[Results]In this series,the elderly(age ≥ 65 years old)patients(elderly group,n= 164)accounted for 37.4%,young and middle-aged(age 65 years)patients(non-elderly group,n= 275)accounted for 62.6%.Compared with the young and middle-aged group,the elderly group had a higher proportion of cholelithiasis,a higher proportion of severe acute pancreatitis(SAP),a higher incidence of infectious pancreatic necrosis(IPN)and persistent(>48 h)organ failure,a longer hospital stay and a higher mortality rate,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of acute peripancreatic fluid collection(APFC),acute necrotic collection(ANC),walled-off necrosis(WON),pancreatic pseudocyst(PPC)and transient(≤48 h)organ failure between the two groups(P>0.05).[Conclusion]The elderly patients with AP are more likely to develop IPN and persistent(48 h)organ failure,SAP accounts for a high proportion,and the prognosis is worse than that of the young and middle-aged patients.
作者
林燕
林五连
孙东杰
王雯
李达周
李海涛
LIN Yan;LIN Wu-lian;SUN Dong-jie;WANG Wen;LI Da-zhou;LI Hai-tao(Department of Gastroenterology,Fuzhou Second Hospital Affiliated to Xiamen University,350007 Fuzhou,China;Department of Gastroenterology,900th Hospital of the Joint Logistics Support Force,350025 Fuzhou,China)
出处
《临床消化病杂志》
CAS
2023年第4期272-275,共4页
Chinese Journal of Clinical Gastroenterology
基金
福州市科技计划项目(No:2021-S-157)。
关键词
急性胰腺炎
老年
并发症
死亡
acute pancreatitis
elderly patients
complication
mortality
