妊娠期高脂血症性急性胰腺炎临床分析

Clinical analysis of hyperlipidemic acute pancreatitis in pregnancy

目的探讨妊娠期高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)的临床特点及血浆置换联合血液净化治疗疗效。方法对2013年12月至2017年2月厦门大学附属第一医院收治的11例妊娠期HLAP患者的临床资料进行回顾性分析。结果患者平均年龄27.3岁,妊娠中期1例,晚期10例,重症患者4例,6例患者行血浆置换联合血液净化治疗。中上腹痛为首发症状,主要合并症:胸腔积液,肺不张;重症患者突出特点:腹腔广泛渗液。血浆置换联合血液净化快速降低血甘油三脂、胆固醇、心率及呼吸频率(P<0.05),但对白细胞、血小板影响不明显(P> 0.05)。结论妊娠期HLAP多发于妊娠晚期(90.9%),重症患者占比36.4%。血浆置换联合血液净化能快速有效降低血脂水平,临床疗效确切。妊娠期积极防治高脂血症有重要意义。

Objective To discuss the clinical features of hyperlipid acute pancreatitis(HLAP)in pregnancy and the therapeutic effect of plasma exchange combined with blood purification.Methods The clinical data of 11 cases of HLAP in pregnancy treated by The First Affiliated Hospital of Xiamen University were analyzed retrospectively.Results The average age of the patients was 27.3 years,1 case in the middle of pregnancy,10 cases in the late stage.In 4 cases of severe patients,6 patients underwent plasma exchange combined with blood purification.Abdominal pain was the first symptom,mainly complications:pleural effusion,pulmonary atelectasis.Prominent features:extensive peritoneal fluid penetration.Plasma exchange combined with blood purification can rapidly reduce triglycerides,cholesterol and lower heart rate and respiration rate (P <0.05),but no significant effect on white blood cells and platelets (P >0.05).Conclusion HLAP is more common in late pregnancy (90.9%) and 36.4% in severe cases.Plasma exchange combined with blood purification can effectively reduce blood lipid level and clinical efficacy.It is important to actively prevent hyperlipidemia during pregnancy.