老年急性出血坏死性胰腺炎是一种高危急腹症。随着老年胆道结石发生率的增多,本病的发生率有上升趋势。我院从1980年5月至1991年5月,外科治疗老年急性出血坏死性胰腺炎28例。本文就外科在治疗本病中的有关问题加以讨论。 1 临床资料本组28例中男9例,女19例。年龄60～79岁(平均67.6岁)。死亡7例,病死率25%。存活者21例,住院47～186天,平均78天。发病诱因:胆道感染,胆道结石23例(82.1%),暴饮暴食1例(3.6%),慢性胰腺炎4例(14.3%)。主要临床表现:本组病例均有上腹痛,腹胀,呕吐,腹膜炎体征,体温>38℃者21例,脉搏>120次/分者19例,休克(收缩压<12kPa)11例。 Acute hemorrhagic necrotizing pancreatitis is a high-risk acute abdomen. With the increasing incidence of biliary stones in older patients, the incidence of this disease is on the rise. Our hospital from May 1980 to May 1991, surgical treatment of 28 cases of senile acute hemorrhagic necrotizing pancreatitis. This article discusses the issues related to the surgical treatment of this disease. 1 Clinical data The group of 28 males in 9 cases, 19 females. Ages 60 to 79 years old (average 67.6 years old). 7 died, the fatality rate was 25%. Survival in 21 cases, hospitalized 47 ~ 186 days, an average of 78 days. Incidence of biliary tract infection, biliary stones in 23 cases (82.1%), binge eating in 1 case (3.6%), chronic pancreatitis in 4 cases (14.3%). The main clinical manifestations: The group of patients had abdominal pain, bloating, vomiting, peritonitis signs, body temperature> 38 ℃ in 21 cases, pulse> 120 beats / min in 19 cases, shock (systolic blood pressure <12kPa) in 11 cases.