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中华产科急救电子杂志 ›› 2013, Vol. 02 ›› Issue (02) : 132 -135. doi: 10.3877/cma.j.issn.2095-3259.2013.02.011

所属专题: 经典病例 文献

论著

妊娠合并急性胰腺炎23例诊治分析
李天1, 陈素华1, 蔡浩东1, 黎宁1,()   
  1. 1. 430030 武汉,华中科技大学同济医学院附属同济医院妇产科
  • 收稿日期:2013-03-13 出版日期:2013-05-18
  • 通信作者: 黎宁

Clinical analysis of pregnancy complicating acute pancreatitis: 23 cases reports

Tian LI1, Su-hua CHEN1, Hao-dong CAI1, Ning LI1,()   

  1. 1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
  • Received:2013-03-13 Published:2013-05-18
  • Corresponding author: Ning LI
  • About author:
    Corresponding author: LI Ning, Email:
引用本文:

李天, 陈素华, 蔡浩东, 黎宁. 妊娠合并急性胰腺炎23例诊治分析[J]. 中华产科急救电子杂志, 2013, 02(02): 132-135.

Tian LI, Su-hua CHEN, Hao-dong CAI, Ning LI. Clinical analysis of pregnancy complicating acute pancreatitis: 23 cases reports[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2013, 02(02): 132-135.

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。

Objective

To investigate the pathogenesis, early diagnosis and treatment of pregnancy complicating acute pancreatitis (AP).

Methods

We 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.

Results

In 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.

Conclusions

Biliary 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.

图1 急性胰腺炎患者的超声图像。可见胰腺肿大(箭头),胰腺内及周围回声减低
表1 两组患者妊娠结局比较
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