Acute Pancreatitis in Pregnancy
Acute Pancreatitis in Pregnancy
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DOI：
10.1097/01.aoa.0000414063.55545.a4
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发表时间：
2012-06
期刊：
影响因子：
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通讯作者：
L. Sun;W. Li;Y. Geng;B. Shen;J. Li
中科院分区：
文献类型：
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作者：
L. Sun;W. Li;Y. Geng;B. Shen;J. Li
目的.孕期胰腺炎母婴风险最高的可能是最严重的病例，我们将其与轻症病例进行了比较。设计。回顾性观察研究。背景。中国南京市一所大学转诊医院的普通外科。人群。18 例妊娠合并重症急性胰腺炎和 51 例妊娠合并轻度急性胰腺炎。方法。回顾了每名妊娠期间患有轻度或重症急性胰腺炎的孕妇的病历。 1999年1月至2009年12月。主要结果指标。人口统计学信息、临床和实验室数据、母婴结局。结果。重症急性胰腺炎组的发病胎龄显着高于轻度急性胰腺炎组。严重高甘油三酯血症被认为是重症急性胰腺炎的主要原因（OR 20.7；95% CI 4.6-92.4，p<0.001），而胆道疾病是轻度急性胰腺炎的病因（OR 7.3；95% CI 1.8-30.1，p<0.01）。轻度组中流产和早产是导致胎儿流产的原因，而重度组中胎儿死亡和死产是导致胎儿丢失的原因。结论：高脂血症性胰腺炎和胆源性胰腺炎分别是重症组和轻症组的主要原因。妊娠期重症急性胰腺炎通常发生在妊娠晚期，重症患者更容易病情危重，导致胎儿宫内死亡的风险较高。
Objective.The highest maternal–fetal risk from pancreatitis in pregnancy is likely to be posed by the most severe cases, which we have compared with mild cases.Design.Retrospective observational study.Setting.A general surgery department of a university referral hospital in Nanjing, China.Population.Eighteen pregnancies complicated with severe acute pancreatitis and 51 pregnancies complicated with mild acute pancreatitis.Methods.Medical records were reviewed for every pregnant woman with mild or severe acute pancreatitis during January 1999 to December 2009.Main Outcome Measures.Information on demographics, clinical and laboratory data, maternal and fetal outcomes.Results.Gestational age of onset was significantly higher in the severe acute pancreatitis group than in the mild acute pancreatitis group. Severe hypertriglyceridemia was considered the main cause of severe acute pancreatitis (OR 20.7; 95% CI 4.6–92.4,p<0.001), while biliary disease contributed to the etiology of mild acute pancreatitis (OR 7.3; 95% CI 1.8–30.1,p<0.01). Abortions and preterm infants contributed to fetal loss in the mild group, while fetal death and stillbirth contributed in the severe group.Conclusions.Hyperlipidemic pancreatitis and biliary pancreatitis are the main causes of severe and mild disease, respectively. Severe acute pancreatitis in pregnancy usually occurs in the third trimester, and the affected severe patients are more liable to develop a critical condition that results in higher risk of intrauterine fetal death.