妊娠合并急性胰腺炎23例诊治分析

目的探讨妊娠期妇女并发急性胰腺炎的原因、临床早期诊断方法以及治疗措施。 方法回顾性分析2008年1月至2012年12月华中科技大学同济医学院附属同济医院收治的23例妊娠合并急性胰腺炎患者的临床资料，将其分为轻症组(16例)及重症组(7例)，两组间计数资料比较采用Fisher确切概率法。 结果23例中合并胆道疾病8例(34.8%)，高脂血症9例(39.1%)；重症组血糖升高率达100%，较轻症组(12.5%)显著增高(P＝0.000)，12例晚期妊娠分娩新生儿均存活，中期及晚期妊娠引产各1例，1例重症急性胰腺炎合并多器官功能衰竭患者母儿死亡，其余8例治愈出院继续妊娠。 结论妊娠合并急性胰腺炎的发生与胆囊疾病和高脂血症有关，早期诊断、个体化治疗、适时终止妊娠是提高治愈率的有效手段。

Clinical analysis of pregnancy complicating acute pancreatitis: 23 cases reports

ObjectiveTo investigate the pathogenesis, early diagnosis and treatment of pregnancy complicating acute pancreatitis (AP). MethodsWe performed a retrospective analysis study on the clinical features, laboratory data, and outcomes in 23 pregnancy women complicating AP, who were treated in Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from January 2008 to December 2012. All patients were divided into 2 groups, mild AP (MAP) group and sever AP (SAP) group. There were16 pregnancies in mild AP (MAP) group and 7 pregnancies in severe AP (SAP) group. Fisher′s exact probabilities were used to compare categorical data. ResultsIn the 23 patients, 8 patients (34.8%) had biliary disease and 9 patients (39.1%) had hyperlipidemia. Patients with hyperglycemia in SAP group were significantly increased than in MAP group (100% vs 12.5%, P=0.000). Twelve pregnancies delivered in the third trimester of pregnancy, and their newborns were alive. One patient induced labor in the first trimester and another one induced labor in the second trimester. One patient died of multiple organ failure and resulted in intrauterine death. The other 8 patients were completely cured and discharged from the hospital. ConclusionsBiliary disease and hyperlipidemia were related with pregnancy complicating AP. Early diagnosis, individual treatment and timely termination of pregnancy should be an effective way to increase the curative ratio.