妊娠期急性胰腺炎：单中心20年52例分析

发布时间：2018-02-04 14:46

本文关键词： 妊娠期急性胰腺炎高脂血症　出处：《中南大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的总结妊娠期急性胰腺炎(APP)的发病特点和预后及20年的变迁,探讨其临床诊治要点。方法回顾性分析近20年(1994—2013年)中南大学湘雅医院收治的52例APP患者的临床资料。结果52例APP中,孕早期3例(5.8%),孕中期12例(23.0%),孕晚期37例(71.2%)。严重程度分级：轻型胰腺炎26例(50.0%),中度重症胰腺炎13例(25.0%),重症胰腺炎13例(25.0%)。病因方面：高脂血症性胰腺炎28例(53.8%),胆源性胰腺炎14例(27.0%),特发性胰腺炎10例(19.2%)。全组APP患者(孕产妇)的病死率为零,胎儿病死率为19.2%(10/52),其中2例胎死宫内,4例早产后新生儿窘迫,4例考虑药物对胎儿影响而行流产或引产。20年间我院收治的APP病人数逐年上升,其中高脂血症性APP所占比例逐年增高。结论APP的发病率呈逐年上升趋势,多数APP发生于孕晚期。高脂血症和胆道疾病是APP的主要病因,其中高脂血症所占比例尤为突出。APP仍伴有较高的胎儿死亡率,进一步规范APP的治疗和加强围产期新生儿的护理对于改善APP总体预后具有重要价值。
[Abstract]:Objective to summarize the characteristics and prognosis of acute pancreatitis in pregnancy (APP) and its changes in 20 years, and to discuss the main points of clinical diagnosis and treatment. Methods the clinical data of 52 patients with APP in Xiangya Hospital of Central South University from 1994 to 2013 were retrospectively analyzed. Results among the 52 cases of APP, 3 cases were in the first trimester of pregnancy, and 12 cases in the second trimester. Grade of severity: 26 cases with mild pancreatitis (50.0%) and 13 cases with moderate severe pancreatitis (25.0%). The causes of severe pancreatitis were as follows: 28 cases with hyperlipidemic pancreatitis (53.8%) and 14 cases with biliary pancreatitis (27.0%). There were 10 cases of idiopathic pancreatitis (n = 10) with APP. The mortality of pregnant and parturient women was zero, the fetal mortality was 19.210 / 52, and 2 of them died in the uterus. 4 cases of neonatal distress after preterm delivery 4 cases of APP patients who were treated with abortion or induced labor considering the influence of drugs on fetus increased year by year and the proportion of hyperlipidemic APP increased year by year. Conclusion the incidence of APP is increasing year by year, and most of APP occurs in late pregnancy. Hyperlipidemia and biliary diseases are the main causes of APP. The proportion of hyperlipidemia is especially prominent. App is still accompanied by a higher fetal mortality. Further standardizing the treatment of APP and strengthening the nursing care of perinatal newborns have important value in improving the overall prognosis of APP.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.255

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