摘要
目的:总结妊娠期急性胰腺炎(APP)的发病特点和预后及20年的变迁,探讨其临床诊治要点。方法:回顾性分析近20年(1994—2013年)中南大学湘雅医院收治的52例APP患者的临床资料。结果:52例APP中,孕早期3例(5.8%),孕中期12例(23.0%),孕晚期37例(71.2%);轻型胰腺炎26例(50.0%),中度重症胰腺炎13例(25.0%),重症胰腺炎13例(25.0%)。病因方面:高脂血症性胰腺炎28例(53.8%),胆源性14例(27.0%),特发性胰腺炎10例(19.2%)。全组孕产妇病死率为0;胎儿病死率为19.2%(10/52),其中2例胎死宫内,4例早产后新生儿窘迫,4例因考虑药物对胎儿影响而行流产或引产。结论:近20年APP的发病率呈逐年上升趋势,且多数发生于孕晚期,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。APP仍伴有较高的胎儿病死率,进一步规范的治疗和加强围产期新生儿的护理对于改善APP总体预后具有重要价值。
Objective： To review the etiological characteristics and prognosis of acute pancreatitis during pregnancy （APP） as well as its changing trend in the recent 20 years, and investigate the essentials for the clinical diagnosis and treatment of this condition. Methods： The clinical data of 52 APP patients treated in Xiangya Hospital of Central South University over the recent 20 years （ 1994 to 2013 ） were retrospectively analyzed. Results： Of the 52 APP patients, 3 cases occurred in early pregnancy （5.8%）, 12 cases occurred in mid-pregnancy （23.0%） and 37 cases occurred in late pregnancy （71.2%）; 26 cases （50.0%） were mild pancreatitis, 13 cases （25.0%） were moderately severe pancreatitis and 13 cases were severe pancreatitis （25.0%）. As for the causes of APP, 28 cases （53.8%） were hyperlipidemic pancreatitis, 14 cases （27.0%） were biliary pancreatitis and 10 cases （19.2%） were idiopathic pancreatitis. In the entire group, the maternal death was 0, but the fetal mortality reached19.2% （10/52）, which included 2 cases of intrauterine death, 4 cases of neonatal distress after premature delivery and 4 cases of artificial abortion on consideration of the potientially adverse effects exerted by medication. Conclusion： The prevalence of APP has shown an increasing trend in recent 20 years, and most of the cases occur in late pregnanc）r. Hyperlipidemia and especially biliary disease are the main causes for APP. APP is still associated with relatively high fetal mortality, and further standardized therapy and enhanced perinatal care are of important value for improving the overall outcome of APP.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第3期297-300,共4页
China Journal of General Surgery
关键词
胰腺炎
并发症
妊娠
高脂血症
Pancreatitis/compl
Pregnancy
Hyperlipidemias
