目的:分析妊娠合并急性胰腺炎(acute pancreatitis in pregnancy,APIP)患者的类型、临床特征及预后危险因素,探讨APIP的预防及治疗管理.方法:回顾性分析2012年4月-2022年3月绵阳市中心医院收治的96例APIP患者,包括APIP的病因、严重程度、实验室指标、并发症、治疗及预后等.结果:根据疾病严重程度分组,轻症 APIP(mild APIP,MAPIP)49 例(51.04％),中重症 APIP(moderate severe APIP,MSAPIP)27 例(28.12％),重症APIP(severe APIP,SAPIP)20例(20.83％).疾病越重,患者的超敏C反应蛋白越高,血钙及白蛋白水平越低,差异有统计学意义(均P＜0.05).组间血淀粉酶、血脂肪酶、血糖指标的差异均无统计学意义(P＞0.05).APIP的主要病因为高脂血症(45/96,46.87％),胆源性APIP 28例(29.17％),特发性APIP 23例(23.96％).合并有糖尿病的患者高脂血症性APIP发生率更高.高脂血症性APIP更容易出现局部或全身并发症,发展为MSAPIP和SAPIP,差异有统计学意义(P＜0.001).APIP患者的病情越重,胎儿丢失率越高,差异有统计学意义(P＜0.05),高脂血症性APIP更易出现胎儿丢失,差异有统计学意义(P＜0.001).结论:APIP在妊娠晚期发生率高,高脂血症是首要病因,并且高脂血症性APIP更易重症化.胎儿丢失率与APIP的严重程度密切相关.APIP的早期诊断、严重程度的评估及治疗方法的选择对于母婴预后非常重要.
Clinical characteristics and prognosis of acute pancreatitis in pregnancy:a 10-year single-center retrospective analysis
Objective:To analyse the types,clinical characteristics and prognostic risk factors of patients with acute pancreatitis in pregnancy(APIP),and to discuss the prevention and therapeutic management of AP1P.Meth-ods:We retrospectively reviewed 96 APIP cases admitted to Mianyang Central Hospital from April 2012 to March 2022,including APIP types,severity,biochemical parameters,complications,treatment and prognosis.Results:In total,49(51.04％),27(28.12％),and 20(20.83％)patients had mild APIP(MAPIP),moderate to severe APIP(MSAPIP),and severe APIP(SAPIP),respectively.The more severe the disease,the higher the patient's high-sensitivity C-reactive protein and the lower the blood calcium and albumin levels(all P＜0.05).The differ-ences in blood amylase,blood lipase and blood glucose indicators between groups were not statistically significant(P＞0.05).The major cause of APIP in these patients was hyperlipidemia(45/96,46.87％),28 cases(29.17％)suffered from biliary APIP,23 cases(23.96％)suffered from idiopathic APIP.The incidence of hyperlipidaemic APIP was higher in patients with diabetes.Hyperlipidaemic APIP was more likely to develop local or systemic complications,developing MSAPIP and SAPIP(P＜0.001).The more severe the condition of the patient with APIP,the higher the rate of fetal loss(P＜0.05),and hyperlipidaemic APIP was more likely to have fetal loss(P＜0.001).Conclusion:APIP has a high incidence in late pregnancy,hyperlipidaemia is the major cause and hyper-lipidemic APIP is more likely to be severe.The rate of fetal loss is closely related to the severity of APIP.Early diagnosis,assessment of its severity of APIP and choice of treatment are important for the prognosis of mother and child.
acute pancreatitispregnancyhyperlipidaemiafetal loss
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