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妊娠期急性胰腺炎:北京十年多中心回顾性研究。

Acute pancreatitis in pregnancy: a 10-year, multi-center, retrospective study in Beijing.

机构信息

Department of Internal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

BMC Pregnancy Childbirth. 2022 May 17;22(1):414. doi: 10.1186/s12884-022-04742-8.

Abstract

OBJECTIVE

Acute pancreatitis in pregnancy (APIP) is a rare and serious complication during pregnancy. It has acute onset and is difficult to diagnose and treat. The aim of the present study was to describe the etiology, clinical manifestations, and maternofetal outcomes of APIP.

METHODS

We retrospectively reviewed 32 pregnant women who were treated at three tertiary care hospitals in Beijing, China. The correlation between the causes of APIP, severity, laboratory indices, and outcomes was analyzed.

RESULTS

The most common causes of APIP were hypertriglyceridemia (56.2%,18/32) and gallstones (28.1%, 9/32). Hypertriglyceridemia-induced APIP was associated with a higher rate of severe acute pancreatitis (P = 0.025). Serum level of triglycerides showed a positive correlation with the severity of APIP (P = 0.039). The most frequent presentation of APIP was abdominal pain (93.7%, 30/32). There were no maternal or fetal deaths in our study. Apgar scores at 1 min, 5 min, and 10 min of the premature neonates was correlated with the severity of APIP of the mother (P = 0.022; 0.002; 0.002).

CONCLUSION

High level of triglycerides may serve as a useful marker of the severity of APIP. The severity of APIP was associated with higher risk of neonate asphyxia. Appropriate timing of termination of pregnancy is a key imperative for APIP patients.

摘要

目的

妊娠合并胰腺炎(APIP)是妊娠期间罕见且严重的并发症。它起病急,诊断和治疗困难。本研究旨在描述 APIP 的病因、临床表现和母婴结局。

方法

我们回顾性分析了在中国北京的 3 家三级医院治疗的 32 例孕妇。分析了 APIP 的病因、严重程度、实验室指标和结局之间的相关性。

结果

APIP 最常见的病因是高甘油三酯血症(56.2%,18/32)和胆结石(28.1%,9/32)。高甘油三酯血症引起的 APIP 与更严重的急性胰腺炎发生率更高相关(P=0.025)。血清甘油三酯水平与 APIP 的严重程度呈正相关(P=0.039)。APIP 最常见的表现是腹痛(93.7%,30/32)。本研究中无孕产妇或胎儿死亡。早产儿的 1 分钟、5 分钟和 10 分钟 Apgar 评分与母亲的 APIP 严重程度相关(P=0.022;0.002;0.002)。

结论

高水平的甘油三酯可能是 APIP 严重程度的有用标志物。APIP 的严重程度与新生儿窒息的风险增加相关。终止妊娠的时机是 APIP 患者的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec27/9115992/993661362d60/12884_2022_4742_Fig1_HTML.jpg

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