北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (1): 125-129.

• 论著 • 上一篇    下一篇

妊娠期及产后急性胰腺炎的临床分析

李宏亮1*,江元慧2*,魏媛2,赵扬玉2,朱曦1,么改琦1△   

  1. (北京大学第三医院 1. 危重医学科,2. 妇产科,北京100191)
  • 出版日期:2014-02-18 发布日期:2014-02-18

Clinical analysis of acute hyperlipidemic pancreatitis during pregnancy and postpartum period

LI Hong-liang1*, JIANG Yuan-hui2*, WEI Yuan2, ZHAO Yang-yu2, ZHU Xi1, YAO Gai-qi1△   

  1. (1. Department of Critical Care Medicine, 2. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China)
  • Online:2014-02-18 Published:2014-02-18

摘要: 目的:分析总结妊娠期及产后妇女合并急性胰腺炎的临床特征及诊疗经验。方法:回顾性分析1994年至2012年间北京大学第三医院收治的妊娠期及产后合并急性胰腺炎患者,共18例次,总结其临床特点及诊疗过程。结果:与同期产科住院患者人数相比,本组18例次患者所占比例为41.24/10万,年龄32.0(28.0,34.7)岁,妊娠35.0(23.5,37.0)周发病。间质水肿性胰腺炎13例(72.2%),坏死性胰腺炎5例(27.8%)。病因构成中,9例(50.0%)由高脂血症所诱发,7例(38.9%)为胆源性,2例(11.1%)为特发性。按照严重程度划分,轻症6例(33.3%),中等重症7例(38.9%),重症5例(27.8%),8例转入重症监护病房(Intensive Care Unit, ICU)治疗。与非高脂血症性相比,高脂血症性胰腺炎患者的病情更加严重,但母婴预后无明显差异。结论:妊娠及产后合并急性胰腺炎的发病率与普通人群大致一致,主要由胆石症及高脂血症引起。高脂血症性胰腺炎的病情更为严重,但经过积极治疗仍可以有效改善患者预后。

关键词: 妊娠, 产后期, 胰腺炎, 高脂血症, 胆道疾病

Abstract: Objective:To describe the characteristics of acute pancreatitis during pregnancy and postpartum. Methods: From 1994 to 2012, 18 cases of gravida and postpartum women complicated with acute pancreatitis were treated at Peking University Third Hospital and retrospective analysis was performed. Results: The admission rate due to acute pancreatitis was 41.24 per 100 000 admission. The median age was 32.0 (28.0, 34.7) years, with the onset of acute pancreatitis on 35.0 (23.5, 37.0) weeks’ gestation. Of all the cases, 13 (72.2%) were interstitial edematous acute pancreatitis, and 5 (27.8%) were necrotizing. Nine (50.0%) were caused by hyperlipidemia, of which 7 (38.9%) were caused by gallstones, and 2 (1.1%) were idiopathic. Stratified by severity, 6 (33.3%) were mild, 7 (38.9%) were moderately severe and 5 (27.8%) were severe, of which 8 were transferred to Intensive Care Unit. Compared with non-hyperlipidemic acute pancreatitis, cases caused by hyperlipidemia were more severe, however, the prognoses of mothers and infants were good. Conclusion: The incidence of acute pancreatitis during pregnancy and postpartum was similar to that of the regular population, and mostly caused by gallstones and hyperlipidemia. Although acute hyperlipidemic pancreatitis is more severe, the morbidity and mortality of maternal and perinatal could be decreased by aggressive therapy.

Key words: Pregnancy, Postpartum period, Pancreatitis, Hyperlipidemia, Biliary tract diseases

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