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  • 董玲玲,裴锦丹,车荣华,等.妊娠合并急性胰腺炎42例的临床特征及诊疗分析[J].同济大学学报(医学版),2020,41(4):492-496.    [点击复制]
  • DONG Ling-ling,PEI Jin-dan,CHE Rong-hua,et al.Acute pancreatitis in pregnancy: an analysis of 42 cases[J].同济大学学报(医学版),2020,41(4):492-496.   [点击复制]
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妊娠合并急性胰腺炎42例的临床特征及诊疗分析
董玲玲,裴锦丹,车荣华,伍岳琳,花晓琳
0
(同济大学附属第一妇婴保健院产科,上海 201204)
摘要:
目的 分析妊娠合并急性胰腺炎(acute pancreatitis in pregnancy, APIP)的临床特征并总结诊疗经验。方法 对2013年1月—2019年12月同济大学附属第一妇婴保健院收治的42例APIP患者的资料进行回顾性分析。结果 24例为轻症胰腺炎(mild acute pancreatitis, MAP)组,14例为中重症胰腺炎(moderate to severe pancreatitis, MSAP)组,4例为重症胰腺炎(severe pancreatitis, SAP)组。其中SAP组的血淀粉酶、尿淀粉酶、C反应蛋白明显高于MSAP和MAP组,血钙值低于MSAP组和MAP组,38例病例发生于孕晚期。24例为高脂血症性胰腺炎,6例为胆源性疾病性胰腺炎,12例为特发性胰腺炎。高脂血症性胰腺炎中三酰甘油和胆固醇的值明显高于特发性和胆源性胰腺炎。产后CT和产前的MRI均可正确的诊断胰腺炎。B超的诊断的正确率偏低,仅为38%。42例急性胰腺炎合并妊娠孕妇经治疗均痊愈,新生儿仅有1例死亡。结论 高脂血症是妊娠合并胰腺炎的首要病因及影响预后的重要因素,早期诊断和个体化治疗,可以提高APIP患者的母儿结局。
关键词:  妊娠  高脂血症胰腺炎  胆源性胰腺炎  急性胰腺炎  新生儿结局
DOI:10.16118/j.1008-0392.2020.04.016
投稿时间:2020-02-20
基金项目:上海市浦东新区卫生健康委员会联合攻关课题(PW2019D-13)
Acute pancreatitis in pregnancy: an analysis of 42 cases
DONG Ling-ling,PEI Jin-dan,CHE Rong-hua,WU Yue-lin,HUA Xiao-lin
(Dept. of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 201204, China)
Abstract:
Objective To analyze the clinical characteristics of pregnant women with acute pancreatitis. Methods Clinical data of 42 women with acute pancreatitis in pregnancy(APIP) admitted in Shanghai First Maternal and Infant Hospital from January 2013 to December 2019 were retrospectively analyzed. Results There were 24 cases of mild acute pancreatitis(MAP), 14 cases of moderately severe acute pancreatitis(MSAP), and 4 cases of severe acute pancreatitis(SAP). The serum and urine amylase, and serum CRP levels in the SAP group were significantly higher, and the blood calcium values were lower than those in the MSAP and MAP groups. The acute pancreatitis of 38 cases occurred in the third trimester. Twenty four cases were hyperlipidemia pancreatitis, 6 cases were biliary disease pancreatitis, and 12 cases were idiopathic pancreatitis. The values of triglycerides and cholesterol were significantly higher in hyperlipidemia pancreatitis than those in idiopathic and biliary pancreatitis. Postnatal CT and prenatal MRI can correctly diagnose pancreatitis; while the diagnostic accuracy of uotrasonography was only 38%. All of 42 patients with APIP were cured after treatment, only one newborn death occurred. Conclusion Hyperlipidemia is the primary cause of AP in pregnancy, which is an important factor affecting the prognosis. Early diagnosis and individualized treatment can improve the maternal and neonatal outcomes of patients with pancreatitis.
Key words:  pregnancy  hyperlipidemia pancreatitis  biliary pancreatitis  acute pancreatitis  neonatal outcomes

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