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目的探讨老年急性胰腺炎(AP)的临床特点及治疗。方法回顾性分析78例老年急性胰腺炎的病例临床资料。结果78例老年AP中合并其他内科疾病59例,其中合并2种者23例,3种及以上者6例;有胆道病史者47例。发病前有饮酒史者14例,暴饮暴食者12例,其他原因者5例。以腹痛为首发症状69例,以其他症状为首发表现者9例。轻型急性胰腺炎67例,重症急性胰腺炎(SAP)11例;SAP中手术治疗7例,4例行胆道引流术和胰周引流术,3例单纯行胰周引流术。死亡3例,2例因术后分别发生严重肺部感染和上消化道大出血,1例因家属拒绝手术最后死亡。结论老年急性胰腺炎患者合并内科疾病多,临床表现复杂、并发症多;老年AP要严格掌握手术适应症和及时采取适当的手术方式。
Objective To investigate the clinical features and treatment of senile acute pancreatitis (AP). Methods A retrospective analysis of 78 cases of elderly patients with acute pancreatitis clinical data. Results Among 78 elderly APs, 59 cases were complicated with other internal diseases. Among them, 23 cases were combined with 2 cases and 6 cases were 3 or more. 47 cases had biliary history. Premorbid drinking history in 14 cases, binge eating in 12 cases, other reasons in 5 cases. Abdominal pain as the first symptom in 69 cases, with other symptoms as the first performance in 9 cases. There were 67 cases of mild acute pancreatitis, 11 cases of severe acute pancreatitis (SAP), 7 cases of surgical treatment of SAP, 4 cases of biliary drainage and peripancreatic drainage, and 3 cases of simple pancreatic drainage. 3 died, 2 patients suffered severe pulmonary infection and upper gastrointestinal bleeding respectively after operation, and 1 patient died of rejection due to family members. Conclusions The elderly patients with acute pancreatitis complicated by medical diseases, complicated clinical manifestations, complications and more; elderly AP should strictly control the indications for surgery and take timely and appropriate surgical methods.