妊娠期急性胰腺炎的临床探讨

The clinical study of pregnancy complicated with acute pancreatitis

目的探讨妊娠期急性胰腺炎的病因、临床特征及发病机理。方法将我院1992年1月1日-2003年12月31日收治的881例急性胰腺炎分成妊娠组（61例）和对照组（820例），对比分析其病因、并发症和病死率。结果胆系疾病仍然是妊娠期急性胰腺炎的主要病因，重症急性胰腺炎的比例高于对照组（P=0．026），妊娠组胸腔积液，代谢性酸中毒、腹腔积液、低钙血症、低氧血症、高脂血症、肠麻痹、胰腺及胰周感染等并发症的发生率明显高于对照组（P〈0．05）；病死率也高于对照组（P=0．003）。结论妊娠期急性胰腺炎的胎儿及新生儿死亡率高，妊娠不但通过促进胆系疾病和高脂血症的发生，诱发急性胰腺炎，其还可以直接促进急性胰腺炎的病理生理过程的发展。

Objective To study the pathogeny, clinical character and mechanism of pregnancy complicated with acute pancreatitis. Methods The 881 cases of acute pancreafitis that had been treated in our hospital from January 1,1992 to December 31,2003 were divided into 2 groups：pregnancy group and control group. The pathogenys, complications, and mortality had been analyzed respectively, Results The diseases of the system of bile duct are the important basic diseases of pregnancy complicated with acute pancreatitis. The incidences of pleural effusion,metabolic acidosis, ascites, hypocalcium, hypoxygen, hyperlipidemia, intestinaI paralysis and infection of pancreas control group in the same term（ P 〈0. 05 ）. Rates of severe acute pancreafitis in the mortality were higher than control group （ P = 0. 003 ）. Conclusion pregnancy not only play a n important role in acute pancreatitis by complicating the disease of the system of bile duct and hyperliopemia but also straightly promote the process of pathology and physiology of acute pancreatitis.