62例妊娠合并急性胰腺炎不同时期的临床特征及结局分析

Clinical Feature and Outcomes Analysis of 62 Pregnancy Complication with Acute Pancreatitis in Different Period

目的:探讨妊娠不同时期合并急性胰腺炎的临床特征及治疗结局。方法:回顾性总结2005年1月至2007年12月收治的妊娠合并急性胰腺炎患者62例的临床资料,分析孕早、中、晚期及产褥期不同时期的合并症、并发症、实验室指标及妊娠结局。结果:孕早、中、晚期及产褥期急性胰腺炎发生率分别为6.45%、17.74%、58.06%和17.74%;不同时期患者血甘油三酯、血淀粉酶和血脂肪酶各组间两两比较,差异有统计学意义(P<0.05);孕早、中、晚及产褥期孕产妇死亡率分别为0、9.09%、5.56%和0,孕早、中、晚期围生儿丢失率分别为25.00%、9.09%和25.00%。结论:妊娠合并急性胰腺炎多发生于孕晚期,胆道疾病和高脂血症是其主要诱因。及时诊治,适时终止妊娠,可望提高治愈率,降低母儿死亡率。

Objective：To investigate the clinical features and outcomes of acute pancreatitis （APIP） in different period.Methods：The clinical features in 62 patients of APIP from 2005 to 2007 were reviewed by retrospective study. The complications, concurrent disease, laboratory index and pregnant outcomes in the first, second, third trimester and puerperium were analyzed. Results-The incidence of APIP in the first, second, third trimester and puerperium was 6.45%, 17.74%, 58.06% and 17.74% respectively. There were significant differences of triglyc- eride, hemodiastase and hemolipase in gravida in different period（ P 〈 0.05）. The mortality of mothers in APIP in dif- ferent period was 0, 9.09%, 5.56%, 0, respectively, while the lost rate of fetus was 25.00%, 9.09% and 25.05%, respectively. Conclusions.APIP often occurs in the third trimester. Disease of biliary tract and hyperlipid- mia are the main causes. Making the correct diagnosis and proper treatment, timely termination of pregnancy will ef- fectively increase curative rate and reduce mortality of gravida and fetus.