妊娠合并急性胰腺炎的临床特征与预后分析

袁景; 孟飞; 汤小伟; 陈霞; 彭燕

doi:10.3969/j.issn.1001-5256.2019.01.026

妊娠合并急性胰腺炎的临床特征与预后分析

DOI: 10.3969/j.issn.1001-5256.2019.01.026

西南医科大学附属医院消化内科

基金项目:

国家自然科学基金(81600420)；

详细信息

中图分类号: R714.255
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出版历程
- 出版日期: 2019-01-20

Clinical features and prognosis of acute pancreatitis in pregnancy

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China

Research funding:

摘要

摘要:
目的提高对妊娠合并急性胰腺炎（APIP）的认知,探讨APIP预防及治疗措施。方法选取西南医科大学附属医院2013年1月-2017年12月收治的APIP患者65例为研究对象。其中轻症急性胰腺炎（MAP） 32例,中度重症急性胰腺炎（MSAP）21例,重症急性胰腺炎（SAP） 12例,对比3组患者实验室检查结果、影像学检查结果、产妇年龄、妊娠并发症、BMI、病因、孕期、产妇及胎儿结局。符合正态分布且方差齐的计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验;非正态分布的计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Dunn-Bonferroni检验。计数资料组间比较采用χ2检验。结果36例（55. 38%）患者血淀粉酶高于正常值上限3倍,41例（63. 08%）患者血脂肪酶高于正常值上限3倍。其中SAP组的超敏C反应蛋白、TG、血糖明显高于MAP组和MSAP组（P值均<0. 05）,血钙明显低于MAP组和MSAP组（P值均<0. 05）。65例患者均行腹部彩超检查,正确诊断51例（78. 46%）; 28例患者行CT检查,正确诊断2...
- 胰腺炎 /
- 妊娠 /
- 高脂血症 /
- 临床特点 /
- 预后
Abstract:
Objective To investigate the preventive and treatment measures for acute pancreatitis in pregnancy (APIP) , and to improve the awareness of this disease.Methods A total of 65 patients with APIP who were admitted to The Affiliated Hospital of Southwest Medical U-niversity from January 2013 to December 2017 were enrolled as subjects.Among these patients, 32 had mild acute pancreatitis (MAP) , 21had moderate-severe acute pancreatitis (MSAP) , and 12 had severe acute pancreatitis (SAP) .The three groups were compared in terms of laboratory results, maternal age, pregnancy complications, body mass index (BMI) , etiology, pregnancy, and maternal and fetal outcomes.An analysis of variance was used for comparison of normally distributed continuous data with homogeneity of variance between multiple groups, and the least significant difference t-test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Dunn-Bonferroni test was used for further comparison between two groups.The chi-square test was used for comparison of categorical data between groups.Results Of all patients, 36 (55.38%) had a blood amylase level three times higher than normal, and 41 (63.08%) had a serum lipase level three times higher than normal.The SAP group had significantly higher high-sensitivity C-reactive protein, triglyceride, and blood glucose and a significantly lower blood calcium level than the MAP and MSAP groups (all P<0.05) .All 65 patients underwent abdominal color Doppler ultrasound, among whom 51 (78.46%) had a correct diagnosis;28 patients underwent computed tomography and all of them had a correct diagnosis (100%) .The patients with gestational diabetes mellitus tended to develop MSAP and SAP (χ2=7.809, P=0.020) .The MSAP and SAP groups had a significantly higher BMI than the MAP group (P<0.05) .Of all patients, 26 (40.00%) had hyperlipidemia as the etiology of APIP, among whom 50.00%developed MSAP and 34.62%developed SAP (χ2=20.520, P<0.001) .With the increase in the severity of APIP, the rate of intrauterine death increased, and the 5-minute Apgar score of neonates decreased (χ2=25.381 and 14.821, both P<0.05) .ConclusionHyperlipidemia is the main cause of APIP and a major influencing factor for prognosis.The monitoring of blood lipids and BMI should be strengthened in pregnant women, in order to reduce the incidence rate and severity of APIP.
- pancreatitis /
- pregnancy /
- hyperlipemias /
- clinical features /
- prognosis

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