妊娠期高甘油三酯血症性胰腺炎30例诊治分析

目的 总结妊娠期高甘油三酯血症性胰腺炎（HPP）的临床特点和预后,探讨其诊治要点.方法 回顾性分析1995年2月至2014年2月间我院收治的30例HPP患者的临床资料.结果 30例HPP中,孕中期4例（13.3％）,孕晚期26例（86.7％）;轻型胰腺炎9例（30.0％）,中度重症胰腺炎11例（36.7％）,重症胰腺炎10例（33.3％）.全组HPP患者起病时的平均血清甘油三酯浓度为17.8 mmol/L.孕产妇的病死率为零,胎儿病死率高达26.7 （8/30）,其中3例胎死宫内,3例早产后死于新生儿呼吸窘迫综合征,2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HPP患者数逐年上升,其在所有妊娠期急性胰腺炎中所占比例亦逐年增高.结论 HPP的发病率呈逐年上升趋势,多数HPP发生于孕晚期.HPP仍伴有较高的胎儿病死率,进一步规范HPP的治疗和加强围产期新生儿的护理对于改善HPP总体预后具有重要价值.

Diagnosis and treatment of hypertriglyceridemic pancreatitis in pregnancy in 30 cases

Objective To summarize the clinical features and prognosis of hypertriglyceridemic pancreatitis in pregnancy （HPP）.Methods The clinical data of 30 cases of HPP in our hospital from Feb.1995 to Feb.2014 were retrospectively reviewed.Results There were four cases in the second trimester （13.3％） and 26 cases in the third trimester （86.7％）.Among them,9 cases were of mild pancreatitis （30.0％）,11 cases of moderate severe pancreatitis （36.7％） and 10 cases of severe pancreatitis （33.3％）.The mean level of serum triglyceride was 17.8 mmol/L.The mortality of the pregnant women was zero,but the mortality of the fetus reached as high as 26.7 （8/30）,which included 3 dead in the uterus,3 dead post-partum and 2 artificial abortion due to side effects of the medication.The admission patients of HPP rose gradually during the past 20 years.Conclusion The prevalence of HPP is growing and most of HPP occurr in the late pregnancy.HPP is still associated with high fetal mortality.To further improve the treatment of HPP and enhance the perineonatal care was of great value to improve the overall prognosis of HPP.