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妊娠期急性胰腺炎:相关病症、治疗及并发症的比较

Acute pancreatitis in pregnancy: a comparison of associated conditions, treatments and complications.

作者信息

Gilbert Audrey, Patenaude Valerie, Abenhaim Haim A

出版信息

J Perinat Med. 2014 Sep;42(5):565-70. doi: 10.1515/jpm-2013-0322.

Abstract

OBJECTIVE

Acute pancreatitis is a rare condition in pregnancy. The aim of this study is to compare associated conditions, treatments and complications of pancreatitis in pregnant and age-matched non-pregnant controls.

METHODS

We carried out a population-based retrospective cohort study using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) from 2003 to 2010. A cohort of pregnant women with acute pancreatitis was created and compared to a created age-matched cohort of non-pregnant women with acute pancreatitis at a 1:4 ratio. Comparisons of associated conditions, treatment types, and complications were carried out using unconditional logistic regression.

RESULTS

We identified 7725 cases of acute pancreatitis in pregnancy. As compared to non-pregnant controls, pancreatitis in pregnancy was more likely to be associated with cholelithiasis and less likely with hyperlipidemia and alcohol abuse. Pancreatitis in pregnancy was more likely to be treated with parenteral nutrition and less likely to undergo endoscopic sphincterotomy. As compared to non-pregnant controls, pregnant women with pancreatitis were less likely to have pancreatic pseudocysts/hemorrhage/necrosis, generalized peritonitis, adult respiratory distress syndrome, disseminated intravascular coagulation, and death.

CONCLUSION

Pancreatitis in pregnancy is predominantly caused by cholelithiasis, and unlike in the non-pregnant state, usually has a milder course.

摘要

目的

急性胰腺炎在孕期较为罕见。本研究旨在比较孕期胰腺炎与年龄匹配的非孕期对照组胰腺炎的相关情况、治疗方法及并发症。

方法

我们利用2003年至2010年医疗成本和利用项目全国住院患者样本(HCUP-NIS)开展了一项基于人群的回顾性队列研究。创建了一组患有急性胰腺炎的孕妇队列,并与按1:4比例创建的年龄匹配的患有急性胰腺炎的非孕妇队列进行比较。使用无条件逻辑回归对相关情况、治疗类型和并发症进行比较。

结果

我们确定了7725例孕期急性胰腺炎病例。与非孕期对照组相比,孕期胰腺炎更易与胆石症相关,而与高脂血症和酒精滥用的相关性较小。孕期胰腺炎更可能接受肠外营养治疗,而接受内镜括约肌切开术的可能性较小。与非孕期对照组相比,患有胰腺炎的孕妇发生胰腺假性囊肿/出血/坏死、弥漫性腹膜炎、成人呼吸窘迫综合征、弥散性血管内凝血和死亡的可能性较小。

结论

孕期胰腺炎主要由胆石症引起,与非孕期状态不同,其病程通常较为轻微。

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