CAJ | 학술논문

目的通过分析老年重症急性胰腺炎(SAP)的特点及病情转归.加强对老年SAP的认识.方法收集2005年6月至2007年10月住院的18例误诊为麻痹性肠梗阻的老年SAP患者资料,并与同期住院的58例老年SAP进行比较.结果误诊组首发症状分别为肠梗阻5例,腹胀纳差4例,恶心呕吐3例,慢性便秘3例,腹痛2例,腹泻1例;对照组分别为2例、3l例、9例、3例、11例、1例,其他1例.误诊组通过CT检查确诊13例,腹部超声及血清淀粉酶确诊分别为3例和2例;对照组通过CT检查确诊32例,腹部超声及血清淀粉酶确诊分别为15例和11例,两组相差显著(P<0.05).误诊组病死4例,其中男性2例,女性2例;对照组病死13例,其中男性3例,女性10例.结论老年麻痹性肠梗阻患者应当注意SAP的可能,确诊有赖于腹部CT检查.
목적 통과분석노년중증급성이선염(SAP)적특점급병정전귀.가강대노년SAP적인식.방법 수집2005년6월지2007년10월주원적18례오진위마비성장경조적노년SAP환자자료,병여동기주원적58례노년SAP진행비교.결과 오진조수발증상분별위장경조5례,복창납차4례,악심구토3례,만성편비3례,복통2례,복사1례;대조조분별위2례、3l례、9례、3례、11례、1례,기타1례.오진조통과CT검사학진13례,복부초성급혈청정분매학진분별위3례화2례;대조조통과CT검사학진32례,복부초성급혈청정분매학진분별위15례화11례,량조상차현저(P<0.05).오진조병사4례,기중남성2례,녀성2례;대조조병사13례,기중남성3례,녀성10례.결론 노년마비성장경조환자응당주의SAP적가능,학진유뢰우복부CT검사.
Objective The clinical features of elderly patients with severe acute pancreatitis (SAP) were atypical and these patients were often misdiagnosed as having paralytic ileus. The clinical presentations of elderly patients with SAP whose first diagnosis as paralytic ileus were analyzed. Methods 18 patients of elderly SAP who were misdiagnosed as having paralytic ileus were included and the clinical data were compared with 58 elderly patients with SAP. Results Among the misdiagnosis group, the first symptom onset were fleus, abdominal distension, vomiting, constipation, abdominal pain, diarrhea for 5, 4, 3, 3, 2, 1 case, respectively. Among SAP group, the first symptoms onset were 2, 31, 9, 3, 11, 2 cases, respectively. For misdiagnosis group, 13 cases were correctly diagnosed by CT scan, 3 cases by ultrasound and 2 cases by serum amylase test. For SAP group, 32, 15, 11 cases were diagnosed by CT scan, ultrasound and serum amylase, respectively (P < 0.05). 4 and 13 patients died in misdiagnosis and SAP group, respectively; among these 13 patients, 10 were female and 3 were male. Conclusions The elderly patients with paralytic ileus should consider the possibility of SAP, and CT scan was valuable for correct diagnosis.