中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
CHINESE JOURNAL OF MULTIPLE ORGAN DISEASES IN THE ELDERLY
2015年
4期
243-246
,共4页
吴鹏飞%苗毅%李强%戴存才%蒋奎荣%吴峻立%高文涛%郭峰%陈建敏%卫积书%陆子鹏%黄东亚
吳鵬飛%苗毅%李彊%戴存纔%蔣奎榮%吳峻立%高文濤%郭峰%陳建敏%衛積書%陸子鵬%黃東亞
오붕비%묘의%리강%대존재%장규영%오준립%고문도%곽봉%진건민%위적서%륙자붕%황동아
胰腺炎,急性%老年人%临床特点%治疗
胰腺炎,急性%老年人%臨床特點%治療
이선염,급성%노년인%림상특점%치료
pancreatitis,acute%elderly%clinical features%therapy
目的：探讨老年急性胰腺炎（AP）患者的临床特征和诊疗效果。方法回顾性地分析南京医科大学第一附属医院胰腺中心2012年1月至2014年12月期间收治的164例老年AP患者（老年组，年龄≥60岁）临床特征和疗效，并与同期收治的309例非老年AP患者（对照组，年龄＜60岁）进行对比分析。结果老年组AP的主要病因为胆道疾病，其次为高脂血症，老年组胆源性AP发生率明显高于对照组（84.15% vs 59.55%，P＜0.001），高脂血症性AP发生率明显低于对照组（9.14% vs 31.07%，P＜0.001）。老年组和对照组主要全身并发症均为脏器功能衰竭（20.12% vs 18.77%，P＞0.05），但老年组全身感染和持续性全身炎症反应综合征发生率明显高于对照组，两组间差异具有统计学意义（P＜0.05），两组间局部并发症发生率无统计学差异（P＞0.05）。老年组重症急性胰腺炎（SAP）发生率与对照组相当（18.90% vs 18.77%），但病死率明显高于对照组（7.93% vs 3.56%， P＜0.05）。结论老年AP患者合并基础疾病多，易发生全身并发症，发展为SAP后病死率高，临床应予以早期诊断和有效治疗，可改善老年AP患者的预后。
目的：探討老年急性胰腺炎（AP）患者的臨床特徵和診療效果。方法迴顧性地分析南京醫科大學第一附屬醫院胰腺中心2012年1月至2014年12月期間收治的164例老年AP患者（老年組，年齡≥60歲）臨床特徵和療效，併與同期收治的309例非老年AP患者（對照組，年齡＜60歲）進行對比分析。結果老年組AP的主要病因為膽道疾病，其次為高脂血癥，老年組膽源性AP髮生率明顯高于對照組（84.15% vs 59.55%，P＜0.001），高脂血癥性AP髮生率明顯低于對照組（9.14% vs 31.07%，P＜0.001）。老年組和對照組主要全身併髮癥均為髒器功能衰竭（20.12% vs 18.77%，P＞0.05），但老年組全身感染和持續性全身炎癥反應綜閤徵髮生率明顯高于對照組，兩組間差異具有統計學意義（P＜0.05），兩組間跼部併髮癥髮生率無統計學差異（P＞0.05）。老年組重癥急性胰腺炎（SAP）髮生率與對照組相噹（18.90% vs 18.77%），但病死率明顯高于對照組（7.93% vs 3.56%， P＜0.05）。結論老年AP患者閤併基礎疾病多，易髮生全身併髮癥，髮展為SAP後病死率高，臨床應予以早期診斷和有效治療，可改善老年AP患者的預後。
목적：탐토노년급성이선염（AP）환자적림상특정화진료효과。방법회고성지분석남경의과대학제일부속의원이선중심2012년1월지2014년12월기간수치적164례노년AP환자（노년조，년령≥60세）림상특정화료효，병여동기수치적309례비노년AP환자（대조조，년령＜60세）진행대비분석。결과노년조AP적주요병인위담도질병，기차위고지혈증，노년조담원성AP발생솔명현고우대조조（84.15% vs 59.55%，P＜0.001），고지혈증성AP발생솔명현저우대조조（9.14% vs 31.07%，P＜0.001）。노년조화대조조주요전신병발증균위장기공능쇠갈（20.12% vs 18.77%，P＞0.05），단노년조전신감염화지속성전신염증반응종합정발생솔명현고우대조조，량조간차이구유통계학의의（P＜0.05），량조간국부병발증발생솔무통계학차이（P＞0.05）。노년조중증급성이선염（SAP）발생솔여대조조상당（18.90% vs 18.77%），단병사솔명현고우대조조（7.93% vs 3.56%， P＜0.05）。결론노년AP환자합병기출질병다，역발생전신병발증，발전위SAP후병사솔고，림상응여이조기진단화유효치료，가개선노년AP환자적예후。
Objective To investigate the clinical features and treatment efficiency of acute pancreatitis (AP) in the elderly. Methods The clinical data of 164 consecutive elderly patients (elderly group, aged over 60 years) with confirmed AP and 309 non-elderly AP patients (control group, younger than 60 years old) treated in our center in recent 3 years were collected and analyzed retrospectively. The clinical features and treatment efficiency were compared between the 2 groups. Results The most common etiology of AP in the elderly patients was biliary diseases, followed by hyperlipidemia. Compared to control group, the proportion of biliary AP was significantly higher (84.15% vs 59.55%, P<0.001); meanwhile, the percentage of hyperlipidemic AP was obviously lower (9.14% vs 31.07%, P<0.001). The main systemic complication was organ failure in both groups (20.12% vs 18.77%, P>0.05), but the incidence of systemic infection and persistent systemic inflammatory response syndrome was significantly higher in the elderly group than in the control group (P<0.05), and the incidence of local complications had no statistical difference between the 2 groups (P>0.05). The incidence of severe AP was similar in the two groups (18.90% vs 18.77%), however, the elderly group had significantly higher mortality (7.93% vs 3.56%, P<0.05). Conclusion The elderly patients with AP are prone to have systemic complications due to their comorbidities, and then the AP may deteriorate into severe AP with extremely high mortality. Early diagnosis and effective treatment could improve the prognosis of the elderly patients with AP.
