妊娠并发高血脂性重症胰腺炎的诊治

【摘要】 目的 探讨妊娠并发高血脂性重症胰腺炎(hyperlipidemic severe acute pancreatitis，HLSAP）临床诊断与治疗特点。方法 回顾性分析2002年1月一2013年1月广州医学院第三附属医院收治妊娠并发高血脂性重症胰腺炎患者27例临床资料。结果 27例患者，死亡4例，治愈23例，治愈率85．1％。手术治疗17例，应用血液透析滤过治疗21例，存活病例平均住院43天。结论 妊娠并发高血脂性重症胰腺炎的治疗以主要致力于降低TG含量、治疗胰腺炎、保护孕妇和胎儿为主；及时制定适合妊娠期高脂血症性重症胰腺炎的综合性治疗方案，慎重地选择外科手术时机及手术方式，同时多学科协作抢救有利于提高疗效。

Diagnosis and treament of pregnancy-associated hyperlipidemic severe acute pancreatitis

Objective To investigate the management of hyperlipidemia and pregnancy associated severe acute pancreatitis. Methods We retrospectively analyzed the clinical data of 27 cases of pregnancy-associated hyperlipidemic severe acute pancreatitis admitted to hospital from January 2002 to January 2013, the Third Affiliated Hospital of Guangzhou Medical University. Results Among the 27 patients, 4 patients died （the cure rate of 85.1%）, 17 cases underwent surgical treatment and 21 cases received hemodialysis filtration. The average length of hospital stay was 43 days in survival cases. Conclusion For the treatment of pregnancy associated hyperlipidemic severe acute pancreatitis, more intervening measure should be focused on reducing TG levels, treatment of pancreatitis, and protecting pregnant women and fetuses. A comprehensive treatment program for gestational hyperlipidemic severe acute pancreatitis, the aperative timing and the surgical approach, and the muhidisciplinary collaboration rescue are helpful to improve the treatment efficacy.