妊娠期急性胰腺炎的临床特点  

Clinical characteristics of acute pancreatitis during pregnancy

作　　者：汪洋[1] 荆雪[1] 田字彬[1] 丁雪丽[1] 王小玮[1] 解曼[1] 

机构地区：[1]青岛大学附属医院消化内科,山东省青岛市266003

出　　处：《世界华人消化杂志》2015年第29期4738-4744,共7页World Chinese Journal of Digestology

摘　　要：目的:总结妊娠期急性胰腺炎(a c u t e pancreatitis during pregnancy,APP)的病因、临床特点和预后及15年的变迁,并探讨其临床诊治要点.方法:回顾性分析近15年(2000-01-01/2015-01-01)青岛大学附属医院收治的23例APP患者的临床资料,既包括患者年龄、体质量指数、孕周、住院时间、住院花费等数值变量,还包括胎儿性别等分类变量.结果:23例APP中,20例(86.96%)发生于妊娠晚期,中度重症胰腺炎7例(30.43%),重症胰腺炎8例(34.78%).病因方面:高脂血症性胰腺炎13例(56.52%),胆源性4例(17.39%),特发性胰腺炎6例(26.10%).全组孕产妇病死率为4.35%(1/22);胎儿死亡率为13.63%(3/22).与非高脂血症性相比,高脂血症性胰腺炎患者的病情严重,但婴儿出生评分及预后未见明显差异.结论:APP多数发生于孕晚期,高脂血症和胆道疾病是其主要病因,其中前者所占比例尤为突出,高脂血症APP发病率逐年上升,病情较后者严重,并伴有较高的胎儿病死率.AIM：To describe the clinical characteristics and causes of acute pancreatitis during pregnancy（APP）.METHODS：A retrospective analysis of clinical data for 23 pregnant women with acute pancreatitis treated at the Affiliated Hospital of Qingdao University from January1,2000 to January 1,2015,including age,body mass index,gestational age,hospitalization time,hospitalization expenses and other numerical variables,as well as fetal sex and other classification variables.RESULTS：Twenty（86.96%） cases occurred in late pregnancy.Seven（30.43%） cases were moderately severe pancreatitis,and8（34.78%） cases were severe pancreatitis.Thirteen（56.52%） cases were caused by hyperlipidemia,4（17.39%） cases were caused by gallstones and 6（26.10%） cases were idiopathic.Maternal death occurred in 1（4.35%） case,and the rate of fetal mortality was 13.63%（3/22）.Compared with nonhyperlipidemic acute pancreatitis,cases caused by hyperlipidemia were more severe,however,the prognoses of both mothers and infants were good.CONCLUSION：Acute pancreatitis occurs mostly in the third trimester of pregnancy,and is mostly caused by hyperlipidemia and gallstones.The rate of acute pancreatitis in patients with hyperlipidemia is increasing year by year,and it is associated with a high mortality rate of fetuses.

关 键 词：胰腺炎 妊娠 高脂血症 

分 类 号：R714.25[医药卫生—妇产科学]