本文選題：急性胰腺炎 + 妊娠　； 參考：《浙江大學》2014年碩士論文

【摘要】：背景和目的： 妊娠期急性胰腺炎是一種嚴重的妊娠并發(fā)癥,起病急、進展快,如診治不及時,孕產(chǎn)婦及圍產(chǎn)兒病死率高,嚴重威脅母嬰健康。近年來其發(fā)病有增多的趨勢,并已成為部分地區(qū)孕婦急腹癥中致孕產(chǎn)婦死亡的首位病因,因此了解妊娠期急性胰腺炎的發(fā)病原因、機制和臨床特點,對于治療及預防妊娠期急性胰腺炎發(fā)生具有十分重要的意義。本文通過總結2003年1月至2013年12月杭州市第一人民醫(yī)院收治102例的妊娠期急性胰腺炎患者血脂代謝特點和病情特征,分析血脂結果與妊娠期急性胰腺炎發(fā)作以及病情程度的相關性,提高對妊娠期血脂特點和妊娠期急性胰腺炎病情特點的認知。 方法： 將102例妊娠期急性胰腺炎患者依據(jù)妊娠時期不同分為早、中、晚期三組,每組依據(jù)胰腺炎病情嚴重程度分為輕、中、重度三組,隨機選取同期本院體檢中心100例正常育齡婦女和同期在本院孕檢早、中、晚孕期孕婦各100例作為對照組,分析每組患者入院時血脂特點(高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、總膽固醇(TC)、甘油三酯(TG),確定妊娠不同時期血脂結果與胰腺炎發(fā)病和病情特點的關系。 結果： (1)102例妊娠期急性胰腺炎患者,妊娠早、中、晚期分別占18.6%(19/102)、25.5%(26/102)、55.9%(57/102)；輕、中、重度分別占49.0%(50/102)、40.2%(41/102)、10.8%(11/102)；82.4%(84/102)妊娠期急性胰腺炎患者伴高脂血癥(血清TG≥1.7mmol/L),在妊娠中晚期,中重度急性胰腺炎發(fā)生率為62.7%(52/83),高脂血癥性中重度急性胰腺炎占84.6%(44/52)。 (2)早期妊娠中,輕度胰腺炎組、正常妊娠組、非孕妊娠組之間血脂水平(HDL-C、LDL-C、TC、TG)無差別(P0.05),中晚期妊娠中,正常妊娠組血脂水平高于非孕組(P0.05)；輕度胰腺炎組血脂水平與正常妊娠組之間無差異(P0.05)；而LDL-C、TC及TG水平在中重度急性胰腺炎組均高于輕度組(P0.05),其中TG水平明顯高于輕度組(P0.01),但TG在中、重度急性胰腺炎組之間無統(tǒng)計學差異(P0.05)。 (3)2例妊娠晚期高脂血癥性重度急性胰腺炎患者死亡,死亡率1.9%(2/102)；中期妊娠中度急性胰腺炎終止妊娠率83.3%(10/12)；40例晚期妊娠中、重度急性胰腺炎均行剖宮產(chǎn)術終止妊娠,死胎和娩出后死亡8例,圍生期嬰兒死亡率14.0%(8/57)。 結論： 妊娠期輕度急性胰腺炎可伴有輕度高脂血癥(TG≤5.6mmol/L),但病情與血脂水平無相關性；而在妊娠中晚期,明顯高脂血癥是導致中重度急性胰腺炎發(fā)生和孕婦死亡的重要原因,需終止妊娠,圍生期嬰兒死亡率高,控制血脂TG5.6mmol/L對預防妊娠期中重度急性胰腺炎有重要意義。
[Abstract]:Background and purpose: Acute pancreatitis of pregnancy is a serious complication of pregnancy, which has a rapid onset and rapid progress. If diagnosis and treatment are not timely, maternal and perinatal mortality is high, which is a serious threat to maternal and infant health. In recent years, the incidence of acute pancreatitis has been increasing, and has become the first cause of maternal mortality in pregnant women with acute abdomen in some areas. Therefore, to understand the pathogenesis, mechanism and clinical characteristics of acute pancreatitis of pregnancy. It is of great significance for the treatment and prevention of acute pancreatitis in pregnancy. From January 2003 to December 2013, 102 patients with acute pancreatitis during pregnancy were treated in Hangzhou first people's Hospital. To analyze the correlation between blood lipid and severity of acute pancreatitis in pregnancy, and to improve the cognition of the characteristics of serum lipids in pregnancy and the condition of acute pancreatitis in pregnancy. Methods: 102 patients with acute pancreatitis of pregnancy were divided into three groups according to pregnancy. Each group was divided into three groups according to the severity of pancreatitis: mild, moderate and severe. 100 normal women of childbearing age and 100 pregnant women of early, middle and late pregnancy were randomly selected as the control group. The characteristics of serum lipids (HDL-CU, LDL-CU, TCX, TGG) at admission were analyzed in each group. The relationship between the results of serum lipids in different periods of pregnancy and the incidence and disease characteristics of pancreatitis was determined. Results: One hundred and two patients with acute pancreatitis in pregnancy, early, middle and late pregnancy accounted for 18.6% of all patients with acute pancreatitis during pregnancy (serum 鈮，

本文編號：1885726