目的:探討急診室急性胰臟炎不同性別間發生原因,預後因子,併發症及死亡率的差異。 材料與方法:回溯1995年11月1日至1998年10月30日某醫學中心急診室第一次發生急性胰臟炎小於72小時的病人,將病人根據病因分組依據性別探討其致死率,住院時數和併發症包括循環衰竭,呼吸衰竭,腎衰竭,腸阻塞以及感染性胰臟壞死。 結果:共有811病人符合,其中511 (63%)是男性,300 (37.0%)是女性。根據病因男性組前三名為酒精引發(44%),膽結石性(26.6%),原因不明(11.2%);女性前三名則為膽結石性(58.8%),高血脂(15.1%)及原因不明(13.8%)。整體的致死率在男性為(8.4%; 43/511)而女性為(6.3%; 19/300)其中並沒有顯著的差異(p=0.323)。至少有一個併發症在男性(11.3%)而在女性為(15.8%)。住院時間長短在性別並無差異(男性12.7±11.8天;女性11.2±10.7天,p=0.172)。 結論:不同性別急性胰臟炎的病人在總體疾病致死率和併發症方面並無顯著差異,但在個別病因上(酒精引發或膽結石)男性的併發症比率較高。
Background: This study examined the demographic data, the prognostic role of etiology, and the influence of gender on the complication and mortality rates of patients with acute pancreatitis presenting at an emergency department in Taiwan. Method: Patients presenting at a medical center emergency department within 72 hours of the first symptoms of acute pancreatitis between November 1, 1995 and October 30, 1998 were retrospectively evaluated. Patients were classified according to etiology. The mortality rates, length of hospitalization and complications, including circulatory insufficiency, pulmonary insufficiency, renal insufficiency, severe ileus and infected pancreatic necrosis, were recorded and evaluated with regard to etiology and gender. Result: A total of 811 patients fitted the criteria during the 3-year period. Of these patients, 511 (63.0%) were male and 300 (37.0%) were female. According to the etiological definitions, 44.0% of the male patients suffered from acute pancreatitis due to alcohol, followed by biliary lithiasis (26.6%) and idiopathic causes (11.2%). Biliary lithiasis was detected in 58.8% of female patients followed by hyperlipidemia (15.1%) and idiopathic causes (13.8%). The overall mortality rate for male patients (8.4%; 43/511) and female patients (6.3%; 19/300) was not significantly different (p=0.323). At least one complication was observed in 11.3% of male patients and 15.8% of female patients (p=0.549). The length of hospitalization did not differ between genders (male 12.7±11.8 days versus female 11.2±10.7 days; p=0.172). Conclusion: Males had a higher mortality risk in specific etiological groups (alcohol and biliary lithiasis). However, the overall mortality and complication rates did not differ between genders.
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