妊娠合并急性胰腺炎的高危因素及预后评估

发布时间：2018-05-12 07:24

本文选题：妊娠 + 胰腺炎　；参考：《医学研究生学报》2015年01期

【摘要】：目的随着生活水平的不断提升,妊娠合并急性胰腺炎(acute pancreatitis in pregnancy,APIP)的发病率逐年上升,而目前尚无有效的防治措施。文中探讨APIP的高危因素及其预后评估指标,以期为预防与预后评估提供依据。方法回顾性分析2002年1月至2013年8月期间在南京军区南京总医院妇产科住院治疗的70例急性胰腺炎患者临床资料。研究组纳入35例妊娠合并急性胰腺炎患者;对照组纳入同期住院治疗的35例非妊娠女性急性胰腺炎患者。对比分析妊娠合并急性胰腺炎患者发病的相关因素、发病后实验室检查指标的变化及最终结局。结果 2组患者发病的高危因素差异无统计学意义(χ2=0.233,P0.05);与对照组比较,研究组患者血清中胆固醇[(5.07±2.95)mol vs(15.69±7.71)mol]及三酰甘油[(3.82±2.58)mol vs(15.54±7.82)mol]的含量明显升高,差异具有统计学意义(P0.05);研究组与对照组患者白细胞计数[(19.00±5.31)109/L vs(14.98±9.77)109/L]、血红蛋白[(82.77±11.77)g/L vs(101.77±1.50)g/L]、血糖[(8.77±2.76)mol/L vs(6.23±1.99)mol/L]差异均有统计学意义(P0.05);logistic多因素回归分析的结果显示胆固醇、甘油三酯均对妊娠合并急性胰腺炎有预测价值,白细胞计数、血红蛋白量均与最终结局有相关性;研究组在院病死率明显高于对照组,差异具有统计学意义(χ2=3.968,P=0.046),研究组重症急性胰腺炎的患病率明显高于对照组,差异具有统计学意义(χ2=5.510,P=0.019)。结论胆道系统疾病是APIP发病的主要高危因素,其次是高脂血症,同时三酰甘油及胆固醇对APIP患者有预测价值,白细胞计数和血红蛋白量可以对患者的病情及最终结局做出初步评估及预测。
[Abstract]:Objective with the improvement of living standard, the incidence of acute pancreatitis in acute pancreatitis (AP) has been increasing year by year, but there is no effective prevention and treatment at present. The high risk factors and prognostic evaluation indexes of APIP were discussed in order to provide basis for prevention and prognosis evaluation. Methods the clinical data of 70 patients with acute pancreatitis who were hospitalized in gynecology and obstetrics department of Nanjing General Hospital of Nanjing military region from January 2002 to August 2013 were analyzed retrospectively. The study group included 35 pregnant women with acute pancreatitis, while the control group included 35 non-pregnant women with acute pancreatitis. The relative factors of pregnancy complicated with acute pancreatitis, the changes of laboratory examination indexes and the final outcome were analyzed. Results there was no significant difference in high risk factors between the two groups (蠂 ~ (2 +) 0.233U P _ (0.05), compared with the control group, the serum levels of cholesterol [5.07 卤2.95)mol vs(15.69 卤7.71)mol] and triacylglycerol [3.82 卤2.58)mol vs(15.54 卤7.82)mol] in the study group were significantly higher than those in the control group. There were significant differences in leukocyte count between the study group and the control group [19.00 卤5.31 卤10.9% L vs(14.98 卤9.77 卤109 / L], hemoglobin [82.77 卤11.77)g/L vs(101.77 卤1.50)g/L] and blood glucose (8.77 卤2.76)mol/L vs(6.23 卤1.99)mol/L). Triglyceride had predictive value in pregnancy complicated with acute pancreatitis. The white blood cell count and hemoglobin content were correlated with the final outcome. The mortality of the study group in hospital was significantly higher than that in the control group. The prevalence of severe acute pancreatitis in the study group was significantly higher than that in the control group (蠂 ~ 2 = 5.510, P < 0.019). Conclusion Biliary tract disease is the main risk factor for APIP, followed by hyperlipidemia, and triglyceride and cholesterol have predictive value in patients with APIP. White blood cell count and hemoglobin can be used to evaluate and predict the patient's condition and final outcome.
【作者单位】：南京大学医学院附属金陵医院(南京军区南京总医院)妇产科;
【基金】：南京军区南京总医院科研基金(2011012)
【分类号】：R714.25

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