| Objective:To study the clinical features of acute pancreatitis in elderly patients,improving the level of treatment measures.Methods:The retrospective analysis was made on the clinical date of 209 cases of acute pancreatitis from January 2013 to December 2015 in Heze Municipal Hospital,who were divided into two groups with age.They were 106 cases in senile group(?60 years old)and 103 cases in non-senile group(<60 years old).The clinical data of senile group compared with those of non-senile group.Results:(1)The group senile AP a total of 106 cases,the male 51 cases accounted for 48.1%,the female 55 cases accounted for 51.9%,male to female ratio of 1:1.07,there were 103 cases,male to female ratio of 2.81:1,the composition with non-elderly group was significant difference(P<0.05).(2)Etiology:There were 70 cases with biliary pancreatitis in the senile group(66.0%),significantly higher than the non-elderly group(23,22.3%)(P<0.01);but they were followed by alcololism,high fat diet and hyperlipemia in the non-elderly group,significantly higher than the senile group(P<0.01);in the AP patients with unknown causes,the prevalence of the senile group was higher than the non-elderly group.In the study,the prevalence of AP caused by other reasons(such as viral infection,biliary surgery,cancer,autoimmune disease,duodenal diverticula,etc.)was not statistically significant(P >0.05).(3)As for the senile group,the rate of abdominal pain was lower than the non-elderly group(P<0.05),while fever was higher(P<0.05).Abdominal distention,nausea/vomiting,fever,jaundice backache etc were the first treatment in 7 old patients 1 younger patient without significant abdominal pain;and the degree of abdominal pain was lighter than the non-elderly group.The incidence of nausea/vomiting,peritoneal irritation and jaundice inthe two groups were not statistically significant(P>0.05).(4)The detection rate of WBC,urine amylase abnormalities was not statistically significant(P > 0.05);relevance ratio of hepatic unfunction in the senile group was higher than the non-elderly group,in contrast to blood amylase(P<0.01).(5)The senile group had more comorb idities,a total of 76 cases,accounting for 71.7%,significantly higher than the non-elderly group(41,39.8%)(P<0.01).(6)The incidence of pleural effusion,infection,multiple organ dysfunction were higher than the non-elderly group,and the infection was the highest(P < 0.01).(7)The prevalence of MAP in the senile group was lower than the non-elderly group,the difference was statistically significant(P<0.05),while SAP morbidity and mortality were higher(P<0.05),MSAP was not different(P > 0.05).But in three different age groups patients of the senile group(60~,70~,?80),the prevalence of MAP decreased,SAP morbidity and mortality increased,and the risk of MSAP was no significant change with age.(8)The improvement rate of the senile group(89.6%)was lower than the non-elderly group(98.1%),while mortality(6.6%)was higher than the non-elderly group(1.0%),the difference was statistically significant(P<0.05).Conclusions:(1)Biliary etiology was the main causes in the aged,while in the non-elderly,AP caused by alcololism,high fat diet and hyperlipemia was more common;(2)The clinical manifestations of elderly AP is not typical,some elderly AP patients lack of typical abdominal pain,onset by nausea,vomiting,abdominal distention,and they should be paid attention to;(3)The incidence of complications in the aged AP was high,such as systemic infection,MODS,pleural effusion;(4)Prevalence of SAP in the elderly was high,the disease progression was rapid,and the mortality was high. |
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