妊娠晚期合并高脂血症性重症急性胰腺炎14例临床分析.pdfVIP

·10 · 临床误诊误治 ２０15 年 2 月 第 28 卷 第 2 期 Ｃｌｉｎｉｃａｌ Ｍｉｓｄｉａｇｎｏｓｉｓ ＆ Ｍｉｓｔｈｅｒａｐｙ熏 Ｖｏｌ．28熏 Ｎｏ．2熏 February ２０15 妊娠晚期合并高脂血症性重症急性胰腺炎 14例临床分析 冯淑娴,盖梅香,刘文珍 　 　 [摘要]　 目的　 探讨妊娠晚期合并高脂血症性重症急性胰腺炎(severe acute pancreatitis,SAP)的临床特点和诊 治要点。 方法　 对我院1996年9月—2013年9月收治的妊娠晚期合并高脂血症性SAP 14例的临床资料进行回顾性 分析。 结果　 本组发病孕周28~34周5例,34 ~37周7例,37~39周2例;初产妇11例,经产妇3例;均经血脂、血尿 淀粉酶、超声及CT检查明确诊断妊娠晚期合并高脂血症性SAP,其中2例首诊误诊为急性阑尾炎,3例因阴道出血疑 诊胎盘早剥。 14例均行剖宫产术,术后康复出院11例,死亡3例;新生儿死亡3例。 结论　 妊娠晚期合并高脂血症性 SAP病情凶险,易致胎儿宫内窘迫,产前控制血脂和早期确诊是获得良好母婴结局的关键。 　 　 [关键词]　 妊娠末期;妊娠并发症;高脂血症;胰腺炎;误诊;阑尾炎;胎盘早剥 [中国图书资料分类号]　 R714.25　 　 　 [文献标志码]　 A　 　 　 　 [文章编号]　 1002-3429(2015)02-0010-04 [DOI]　 10.3969/ j.issn.1002-3429.2015.02.003 A Clinical Study of 14 Patients with Hyperlipidemia Severe acute Pancreatitis During Late Pregnancy 1 2 1 FENGShu-xian ,GAImei-xiang ,LIUWen-zhen (1. Departmentof GynecologyandObstetrics,AnningSub-Hospital,Gen- eral Hospital of Lanzhou Military Area Commandof ChinesePLA,Lanzhou730070,China;2. Department of Medical Instru- th ments,the 15 Hospital of PLA,Wusu,Xinjiang Uygur Autonomous Region833000,China) [Abstract]　 Objective　 To discuss the clinical characteristics and the key points of diagnosis and treatment of late pregnancy mergedwith hypertriglyceridemia-induced severe acute pancreatitis (SPA). Methods　 Retrospective analysis on the clinical data of 14 casesof latepregnantwomenwithhyperlipidemiaandsevereacutepancreatitiswasconducted. Thepa- tientswere admitted to our hospital for treatment during September 1996 and September 2013. Results　 The onset in the group was at the gestational age of28 to34 weeks (5 cases),34 to37 weeks (7 cases),37 to39 weeks (2 cases) respec- tively. Therewere 11casesof uniparaand3 casesof multiparainallthecases,whosediagnoseswereconfirmedashypertrig- lyceridemia-induced severe acute pancreatitisfollowing examinationsof lipid,blood intheurine amylase,ultrasound and CT. All the patients underwentcae