| 1.The etiology of acute pancreatitisObjective:To investigate the etiology proportion and their clinical characteristics of acute pancreatitis.Methods: The datas of 207 patients with AP,in Beijing Shijitan Hospital,from 2011 to 2015 were analyzed retrospectively.The proportion of the AP etiology was analyzed retrospectively. The genders,ages,clinical types,severities,prognosis of the different etiology were analyzed retrospetively.Result:1)the proportion of etiology Among the 207 pantients with AP,biliary AP and hyperlipidemic AP accounted for 40.1% and 15.5%.Other rare etiology accounted for 18.8%. Idiopathic and alcoholic factors accounted for the fourth, the fifth respectively. Gallstone was always the main cause over time. Hyperlipidemic AP was on the rise.2)etiology and gender In male patients,alcoholic,hyperlipidemic and idiopathic AP were higer than those of female patients,while biliary and other factors were lower.The difference of alcoholic AP was statistically significant(c2=6.388,p<0.05).3) etiology and gender In elderly group,Alcoholic and hyperlipidemic factors were lower than those of non-elderly patients,which were statistically significant(c2=28.662,p<0.01;c2=26.887,p<0.01), while biliary and other factors were higer(c2 =12.766,p<0.01;c2 =11.210,p<0.05).4) etiology and clinical type The recurrence group of hyperlipidemia AP was greater than the primary group,which was statistically significant(c2 = 19.566, p < 0.01), and other groups had no statistical significance. 5) etiology and severity While the non-severe AP accounted for 86.5%,the severe AP accounted for 13.5%.None of group had statistical significance. 6) etiology and prognosis While cure efficient was 95.2%,cure Inefficient was 4.8%.The mortality rate was 3.4%. biliary, alcoholic,hyperlipidemic groups had no statistical significance.Conclusions:Biliary factor was the most common etiology in Beijing,especially for the elderly.Alcoholic and hyperlipidemia AP were more among the young and middle-aged patients. Hyperlipidemia AP was more likely to recur. 2. A comparative study of severe and non-severe AP.Objective:To investigate the differences and similarities of clinical features between severe and non-severe AP,for better understanding of severe AP.Methods: The differences and similarities in clinical manifestations, biochemical indicators within 48 hours after admission, complications, mortality between severe and non-severe AP were analyzed retrospectively.Result:The two group had no abvious differences in clinical manifestations. While the CRP lever was higer in the SAP,the blood calcium lever was lower in the SAP.The differences had statistical significance.(Z=2.810,p<0.05;Z =3.932,p<0.01).The local complications, systemic complications, mortality of SAP were significantly more than those of the non-SAP.The differences had statistically significant.(c2=33.398,p<0.01;c2=134.812,p<0.01;c2=19.566, p<0.01).Conclusions: The two group had similar clinical manifestation.we can’t judge the severity of AP only based on clinical manifestation. The CRP and blood calcium can be used for the indicators of estimating severity and treatment effect. SAP had more complications.The mortality is higher.3. A comparative study of AP between the elderly and non- elderly patientsObjective:To investigate the differences and similarities of AP in clinical features between the elderly and non- elderly patients,for better understanding of AP in the elderly. Methods : The clinical features of acute pancreatitis between the elderly and non- elderly patients were compared and summarized. Result:The non-elderly occurred more abdominal pain, nausea, vomiting.The differences had statistically significance.(c2=13.925,p<0.01;c2=12.079,p<0.05). While the blood amylase lever was higer,the CRP lever was lower in the elderly.The differences had statistical significance.(Z=3.522,p<0.05; Z =3.459,p<0.05).The non-elderly group had more checking cases,abnormal cases,and abnormal detection rate in Computed tomography scan. The differences had statistical significance.(c2=13.717,p<0.01;c2=18.706,p<0.01;c2 =5.944,p<0.05).The incidence of multiple organ dysfunction was higher in the elderly.(c2 =5.286, p<0.05). The systemic complications, mortality of the elderly were more. The differences had statistical significance.(c2=6.886,p<0.01;c2 =3.902,p<0.05). Conclusions: The performance of acute pancreatitis in the elderly was not typical,clinical diagnosis was relatively difficulte.The elderly was more likely to complicate multiple organ failures.The prognosis was worse. |
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