老年重症急性胰腺炎患者的临床特点及预后分析
投稿时间:2016-05-20  修订日期:2016-05-26  点此下载全文
引用本文:李萌芳,任晓蕊,支绍册,洪广亮,赵光举,吴斌,邱俏檬,卢中秋.老年重症急性胰腺炎患者的临床特点及预后分析[J].医学研究杂志,2017,46(1):84-87
DOI: 10.11969/j.issn.1673-548X.2017.01.024
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作者单位E-mail
李萌芳 325000 温州医科大学附属第一医院急诊医学中心  
任晓蕊 325000 温州医科大学附属第一医院急诊医学中心  
支绍册 325000 温州医科大学附属第一医院急诊医学中心  
洪广亮 325000 温州医科大学附属第一医院急诊医学中心  
赵光举 325000 温州医科大学附属第一医院急诊医学中心  
吴斌 325000 温州医科大学附属第一医院急诊医学中心  
邱俏檬 325000 温州医科大学附属第一医院急诊医学中心  
卢中秋 325000 温州医科大学附属第一医院急诊医学中心 lzq640815@163.com 
基金项目:浙江省中医药重点学科计划项目(2012-XK-A28);浙江省“十二五”重点学科建设项目(2012-207);浙江省医学创新学科建设项目(11-CX26)
中文摘要:目的 探讨老年重症急性胰腺炎患者的临床特点及预后影响因素。方法 回顾性分析2010年4月~2014年10月入住笔者医院的46例老年重症急性胰腺炎患者的临床资料,总结其临床特点,采用单因素分析及多因素逐步Logistic回归,分析其死亡相关因素。结果 46例老年重症急性胰腺炎患者中,男性25例(54.35%),女性21例(45.65%),患者年龄72.02±8.70岁,器官衰竭数目(1.5,2)个。最常见的病因是胆源性(61.7%,29/46),腹痛(84.78%,39/46)是最主要的就诊症状,高血压病(69.57%,32/46)是最常见的基础疾病,肺(45.65%,21/46)和肾(47.83%,22/46)是最容易发生衰竭的器官;总病死率41.30%(19/46)。多因素逐步Logistic回归分析显示,血氧分压降低和器官衰竭数目≥2是老年重症胰腺炎患者死亡的独立危险因素。结论 老年重症急性胰腺炎患者并发症多,预后差,病死率高。当出现血氧分压降低或发生器官功能障碍的数目≥2时提示患者预后不良,应予以充分重视及时采取有效治疗。
中文关键词:老年  重症急性胰腺炎  临床特点  预后
 
Severe Acute Pancreatitis in the Elderly: Clinical Characteristics and Prognostic Factors
Abstract:Objective To investigate the clinical characteristics and prognostic factors of severe acute pancreatitis (SAP) in elderly patients (≥ 60 years of age). Methods The clinical data of 46 patients with SAP in First Affiliated Hospital of Wenzhou Medical University from April 2010 to October 2014 were studied retrospectively to summarize its clinical characteristics. Single and multivariate Logistic regression analysis were employed to analyze the risk factors associated with mortality. Results There were 25 males and 2 females with a mean age of 72.02±8.70 years old. The mean number of organ failure was (1.5,2). Biliary etiology (61.7%) was the first cause. Abdominal pain (84.78%) was the main clinical symptom. The hypertension (69.57%) was the most common basic disease. Lung (45.65%, 21/46) and Kidney (47.83%, 22/46) were the organs that most likely to be failed. The overall mortality was 41.30% (19/46).In stepwise logistic regression analysis, the number of failed organ and the decreased of blood oxygen partial pressure were the risk factor associated with death. Conclusion The elderly patients with SAP have high proportion of complication, poor prognosis and high mortality.It must be seriously treated. Timely and effective measures should be adopted when the patient has decreased of blood oxygen partial pressure or more than two numbers of failed organ.
keywords:Elderly  Severe acute pancreatitis  Clinical characteristics  Prognostic factor
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