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【摘要】目的：分析老年人急性胰腺炎（AP）的特点，探索其诊療手段和预后。方法：对2004年1月-2009年8月我院收治的85例老年（60-85岁）AP患者进行分析，并与同期非老年急性胰腺炎（平均≤45岁）患者的临床资料进行对比分析研究。结果：85例AP患者发病原因以胆源性和高脂血症多见，是老年重症胰腺炎的主要诱因，老年组的急性生理和慢性健康评价指标和Ranson评分均明显高于对照组（p<0.01）。老年组的患者易出现低血钙和低蛋白血症及转氨酶增高(p<0.05),出现呼吸衰竭、肾功能衰竭等多器官功能损伤。病死率明显高于对照组（p<0.05）。结论：老年人急性胰腺炎其临床表现多不典型，并发症多，如呼吸系统、消化道、肝、肾、脑等重要器官病变，易合并感染，发展成重症胰腺炎，采取内科保守治疗，并结合中医治疗可取得满意疗效。
【关键词】急性胰腺炎；老年人；临床特点
【中图分类号】R576【文献标识码】B【文章编号】1008-6455（2011）10-0482-01【Abstract】Objective：To analyze the clinical features of acute pancreatitis (AP) in aged patients, and to explore the measures of its diagnosis and treatment．Methods：The clinical data of 85 aged patients (60-85 years old) with AP admitted from January 2004 to August 2009 were reviewed and compared with those of non-aged AP patients (≤45 years old) admitted at the same period.Results：Biliary diseases and hyperlipemia were common causes of these 85 senile AP, which were the main causes of senile severe acute pancreatitis (SAP). Both acute physiology and chronic health evaluation 11 (APACHE 11) and Ranson scores of the aged patients were higher than those of the control group (P<0.01). The incidences of low serum calcium, low albumin and high aminOtransferase (P<0.05), respiratory failure, renal failure and multiple organ dysfunction syndrome as welI as the mortality were higher in the senile group than those in the control group(P<0.05). Conclusions：Senile AP lacks characteristic clinical symptoms and is often associated with multiple complications such as infection and lung，gastrointestinal tract, liver, kidney and brain impairment. Taken in conservative medical treatment combined with traditional Chinese medicine treatment can achieve satisfactory effect.
【Key words】Acute pancreatitis; the elderly; clinical features
【关键词】急性胰腺炎；老年人；临床特点
【中图分类号】R576【文献标识码】B【文章编号】1008-6455（2011）10-0482-01【Abstract】Objective：To analyze the clinical features of acute pancreatitis (AP) in aged patients, and to explore the measures of its diagnosis and treatment．Methods：The clinical data of 85 aged patients (60-85 years old) with AP admitted from January 2004 to August 2009 were reviewed and compared with those of non-aged AP patients (≤45 years old) admitted at the same period.Results：Biliary diseases and hyperlipemia were common causes of these 85 senile AP, which were the main causes of senile severe acute pancreatitis (SAP). Both acute physiology and chronic health evaluation 11 (APACHE 11) and Ranson scores of the aged patients were higher than those of the control group (P<0.01). The incidences of low serum calcium, low albumin and high aminOtransferase (P<0.05), respiratory failure, renal failure and multiple organ dysfunction syndrome as welI as the mortality were higher in the senile group than those in the control group(P<0.05). Conclusions：Senile AP lacks characteristic clinical symptoms and is often associated with multiple complications such as infection and lung，gastrointestinal tract, liver, kidney and brain impairment. Taken in conservative medical treatment combined with traditional Chinese medicine treatment can achieve satisfactory effect.
【Key words】Acute pancreatitis; the elderly; clinical features