妊娠合并高脂血症性胰腺炎12例诊治分析

Diagnosis and treatment of pregnancy complicated with hyperlipidemic pancreatitis:a report of 12 cases

目的探讨妊娠合并高脂血症性胰腺炎(HLAP)的临床特点及诊治方法。方法回顾性分析2010年至2017年本院收治的12例妊娠期HLAP患者的临床资料,对其基本信息、临床表现、实验室检查、影像学检查、治疗方法及预后进行分析。结果 12例HLAP主要发生于妊娠中、晚期,具有复发性。起病的诱因主要为高脂饮食,主要表现为腹痛、呕吐,可能伴随妊娠糖尿病或甲状腺功能减退,血淀粉酶和脂肪酶常升高不明显,伴有假性低钠血症和凝血功能异常,B超、CT是诊断妊娠期HLAP的重要影像学依据,12例妊娠合并急性胰腺炎(APIP)中除1例引产外,其他11例母婴均救治成功。结论针对妊娠期HLAP,重在预防,正确诊断是关键。经过多学科合作联合治疗,母婴通常能取得较好疗效。

Objective To investigate the elinical characteristics,diagnosis and treatment of pregnancy complicated with hyperlipidemic pancreatitis (HLAP).Methods The clinical data of 12 patients with hyperlipidemic pancreatitis in our hospital from 2010 to 2017 were analyzed retrospectively,including general data,clinical manifestations,laboratory examinations,imaging examinations,treatment methods and prognosis.Results 12 cases of HLAP were mainly occurred in the middle and late pregnancy and often recurs.The main cause of the disease was the high fat diet.The main manifestations of the disease are abdominal pain and vomiting.It may be accompanied by gestational diabetes or hypothyroidism.Blood amylase and lipase are often not significantly elevated,with pseudohyponatremia and abnormal coagulation function.Ultrasonography and computed tomography (CT)are important methods for the diagnosis of HLAP.In 12 cases of HLAP,except for one abortion,all the other 11 cases were successfully treated. Conclusions For pregnancy complicated with hyperlipidemic pancreatitis,prevention is the first,and the key is the correct diagnosis.After combined treatment,the patients usually have a good prognosis.