100例老年重症急性胰腺炎临床研究

doi:10.3736/jcim20070308

Abstract

Objective: To analyze the clinical features of severe acute pancreatitis (SAP) in aged patients, and to explore the measures of its diagnosis and treatment.Methods: The clinical data of 100 aged patients (55-85 years old) with SAP admitted from January 2003 to December 2005 were reviewed and compared with those of 221 non-aged SAP patients (11-54 years old) admitted at the same period.Result: Totally 112 times of onset occurred in 100 aged patients, and the main causes for senile SAP were biliary diseases and hyperlipemia. Both acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) and Ranson scores of the aged patients with SAP were higher than those of the control group (P＜0.05); while there was no significant difference in Balthazar score between the two groups(P>0.05). The incidences of low serum calcium, low albumin and high aspartate aminotransferase (P＜0.05), liver, kidney or brain impairment as well as the mortality were higher in the senile SAP group than those in the control group(P＜0.05).Conclusion: Biliary disease and hyperlipemia are the main causes of senile SAP, which lacks characteristic clinical symptoms and is often associated with multiple complications such as infection and lung, gastrointestinal tract, liver, kidney, and brain impairment. Individualized differential treatment with integrated traditional Chinese and Western medicine based on stage classification is an effective approach.

CLC Number:

R576.1

W Huang, P Xue, TT Liu, L Huang, DK Xiang, L Wang, Q Xia. Clinical study on 100 cases of severe acute pancreatitis in aged patients. Journal of Chinese Integrative Medicine, 2007, 5(3): 268-271.

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URL: http://www.jcimjournal.com/EN/10.3736/jcim20070308

http://www.jcimjournal.com/EN/Y2007/V5/I3/268

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References 10

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Group	n	Biliary disease	Fatty diet	Hyperlipemia	Bibulosity	Others	Unclear
Aged	100	49 (49)	15 (15)	24 (24)	6 (6)	9 (9)	15 (15)
Control	221	78 (35.3)**	57 (25.8)*	31 (14.0)*	47 (21.3)**	20 (9.0)	14 (6.3)*

Group	n	Score of grade system
Group	n	Ranson	APACHEⅡ (0 h)	APACHEⅡ (24 h)	Balthazar
Aged	100	4.50±3.41	13.96±6.50	10.41±4.12	4.47±2.09
Control	221	3.63±1.76**	10.49±6.01**	8.43±3.78**	4.52±4.05

Group	n	Glucose>11.1 mmol/L	Ca²⁺＜2.0 mmol/L	Albumin＜32 g/L	AST≥250 U/L	WBC≥1.6×1010/L
Aged	100	53 (53)	76 (76)	54 (54)	13 (13)	40 (40)
Control	221	98 (44.3)	133 (60.2)**	79 (35.7)**	11 (5.0)*	63 (28.5)

Group	n	Lung impairment	Liver impairment	Kidney impairment	GI tract impairment	Brain impairment	Infection	Mortality
Aged	100	71 (71)	57 (57)	21 (21)	42 (42)	18 (18)	19 (19)	20 (20)
Control	221	138 (62.4)	96 (43.4)*	24 (10.9)*	73 (33.0)	16 (7.2)**	43 (19.5)	23 (10.4)

Clinical study on 100 cases of severe acute pancreatitis in aged patients

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