摘要
目的总结并分析妊娠期急性胰腺炎(APIP)的临床特点、诊疗方法和妊娠结局。方法回顾性分析北京协和医院2000年10月至2022年3月收治的40例APIP患者的临床资料,根据疾病严重程度分为轻度急性胰腺炎(MAP)组(26例)和重度急性胰腺炎(SAP)组(14例),比较两组患者的发病诱因、临床特点、诊治方法及妊娠结局。结果患者平均年龄(28.7±6.4)岁(22~45岁);APIP整个孕期均可发病。40例APIP患者无孕妇死亡,活产37例,24例(64.9%)经剖宫产终止妊娠,13例(35.1%)阴道分娩,其中早产20例(54.1%),足月产17例(45.9%);3例胎死宫内行利凡诺引产。MAP组26例患者,占65.0%;SAP组14例患者,占35.0%。两组患者的一般资料、发病原因无显著性差异(P>0.05),而SAP组的平均住院日显著高于MAP组(P<0.05);实验室检查结果中,SAP组的血淀粉酶、C反应蛋白(CRP)显著高于MAP组,血钙值显著低于MAP组(P均<0.05);两组的妊娠结局比较,MAP组的分娩孕周及新生儿出生体重显著大于SAP组,新生儿窒息率显著低于SAP组(P均<0.05)。结论APIP好发于晚孕期,早产、新生儿窒息等不良妊娠结局发生率高。妊娠结局与病情严重程度有关。确诊后根据病因不同采取对症治疗、多学科治疗对改善母婴预后非常关键。
Objective:To analyze the clinical characteristics,diagnosis and treatment of acute pancreatitis in pregnancy(APIP).Methods:The data of 40 APIP patients treated in Peking Union Medical College Hospital from October 2000 to March 2022 were retrospectively analyzed.The patients were divided into mild acute pancreatitis(MAP)group(n=26)and severe acute pancreatitis(SAP)group(n=14),and the pathogenic factors,clinical features,diagnosis&treatment methods and pregnancy outcome were compared between the two groups.Results:The mean age of the patients was(28.7±6.4)29 years(22-45 years).APIP occurred throughout pregnancy.After multidisciplinary treatment,there were no maternal deaths in 40 APIP patients,37 live births including 24(64.9%)termination of pregnancy through cesarean section and 13(35.1%)vaginal deliveries.Among them,20 premature deliveries(54.1%)and 17 full-term deliveries(45.9%).Three patients with intrauterine of fetal death were induced by rivanol.There were 26 patients with MAP(65.0%)and 14 patients with SAP(35.0%).There were no significant differences in the general data and the causes between the two groups(P>0.05),but the average length of stay in SAP group was significantly longer than that in MAP group(P<0.05).In the laboratory examination results,the blood amylase and C-reactive protein(CRP)in the SAP group were significantly higher than those in the MAP group,and the blood calcium value was significantly lower than that in the MAP group(P<0.05).In terms of pregnancy outcomes,gestational weeks and neonatal weight in the MAP group were significantly higher than those in the SAP group,while the incidence of neonatal asphyxia in the MAP group was significantly lower than that in the SAP group(P<0.05).Conclusions:APIP tends to occurs in late pregnancy,with a high incidence of adverse pregnancy outcomes such as premature birth and neonatal asphyxia.The outcome of pregnancy is related to the severity of the disease.After diagnosis,symptomatic treatment and multidisciplinary treatment based on different caus
作者
周倩
高劲松
刘俊涛
宋英娜
刘欣燕
彭萍
ZHOU Qian;GAO Jin-song;LIU Jun-tao;SONG Ying-na;LIU Xin-yan;PENG Ping(Department of Obstetrics&Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,National Clinical Research Center for Obstetric&Gynecologic Diseases,Beijing 100730)
出处
《生殖医学杂志》
CAS
2023年第6期807-812,共6页
Journal of Reproductive Medicine
基金
中央高水平医院临床科研业务费资助(2022-PUMCH-B-075)。
关键词
妊娠
急性胰腺炎
高脂血症
诊断
妊娠结局
Pregnancy
Acute Pancreatitis
Hyperlipidemia
Diagnosis
Pregnancy outcome
