老年急性胰腺炎患者的临床特点及预后研究  

Clinical Features and Outcome of Acute Pancreatitis in Elderly Patients

作　　者：王蓓蓓[1] 廖山婴[1] 聂胜利[1] 沙卫红[1] 布小玲[1] 马娟[1] 

机构地区：[1]广东省人民医院广东省医学科学院消化内科,广东省广州市510080

出　　处：《中国全科医学》2017年第7期800-803,共4页Chinese General Practice

基　　金：国家自然科学基金资助项目(81001112)

摘　　要：目的探讨老年急性胰腺炎(AP)患者的临床特点及预后。方法选取2005年11月—2015年10月广东省人民医院收治的AP患者1 382例。根据年龄,将纳入患者分为老年组(年龄≥60岁,n=678)和对照组(年龄<60岁,n=704)。通过查阅病历的方法,收集两组患者的临床资料,包括性别、年龄、病因、病情分级、并发症、住院时间、复发率及死亡率。结果两组患者性别比较,差异有统计学意义(P<0.05)。对照组和老年组患者由胆源性疾病导致AP的发生率分别为46.4%(327/704)、76.8%(521/678)。两组患者病因比较,差异有统计学意义(P<0.05);病情分级比较,差异无统计学意义(P>0.05)。局部并发症中,老年组患者急性液体积聚、急性坏死物积聚、胰腺假性囊肿发生率低于对照组,差异有统计学意义(P<0.05);两组患者包裹性坏死、胰腺脓肿、胸腔积液、消化道瘘、腹腔出血、假性囊肿出血、脾静脉/门静脉血栓形成、坏死性结肠炎发生率比较,差异无统计学意义(P>0.05)。全身并发症中,对照组患者全身炎性反应综合征、腹腔内高压/腹腔间隔室综合征发生率低于对照组,差异有统计学意义(P<0.05);两组患者器官功能衰竭、全身感染发生率比较,差异无统计学意义(P>0.05)。两组患者住院时间、死亡率比较,差异无统计学意义(P>0.05);老年组患者复发率高于对照组,差异有统计学意义(P<0.05)。结论老年AP患者中女性比例较高,以胆源性胰腺炎最为常见,复发率较高,但病情分级、住院时间、死亡率与非老年患者无差异。Objective To investigate the clinical features and outcome of acute pancreatitis（ AP） in the elderly. Methods The subjects enrolled in this study were 1 382 consecutive AP patients admitted to Guangdong General Hospital from November 2005 to October 2015. By checking medical records,we obtained the clinical data of them,including gender,age,etiology distribution of AP,severity staging of AP,complications,length of stay,recurrence rate and mortality. Based on age,we divided the patients into the elderly group（ aged 60 or over,n = 678） and the control group（ younger than 60 years old,n = 704）. Results Significant gender difference in the incidence of AP was found between the two groups（ P〈0. 05）.The incidence of AP due to biliary disease in the control group and elderly group was 46. 4%（ 327 /704） and 76. 8%（ 521/678）,respectively. Etiology distribution of AP differed remarkably between the groups（ P〈0. 05）,while the severity staging of AP did not（ P〈0. 05）. With regard to the incidence of local complications, the incidences of acute peripancreatic fluid collection,acute necrotic collection and pancreatic pseudocyst were significantly higher in the control group than in the elderly group（ P〈0. 05）,but the incidences of encapsulated necrosis,walled- off pancreatic necrosis,hydrothorax,gastrointestinal fistula,intra- abdominal hemorrhage,pancreatic pseudocyst bleeding,splenic / portal vein thrombosis and necrotic colitis were not（ P〈0. 05）. In terms of the incidence of systemic complications,the incidences of systemic inflammatory response syndrome（ SIRS）,intra- abdominal hypertension（ IAH） or abdominal compartment syndrome（ ACS） were significantly higher in the control group than in the elderly group（ P〈0. 05）,but the incidences of organ failure and systemic infection were not（ P〈0. 05）. Two groups had similar length of stay and mortality（ P〈0. 05）,however,the elderly group had significantly higher recurrence rate（ P〈0. 05）. Conclu

关 键 词：胰腺炎 疾病特征 预后 老年人 

分 类 号：R576[医药卫生—消化系统]