| Objective: The incidence of hyperlipidemic acute pancreatitis in pregnancy was on the rise,because of the changes in diet and the prevalence of prenatal testing.And HLAP was considered as an important cause of severe acute pancreatitis in pregnancy,which seriously threatens the safety of mother and baby.Secondary abdominal infection is still the leading cause of death in SAP patients.This study produced analysis of clinical characteristics of patients with acute pancreatitis during pregnancy,and the influence factors of acute pancreatitis secondary abdominal cavity infection of the hyperlipidemic groups through a retrospective,comparative clinical information collection,might provide reference for clinical diagnosis and treatment and do some help to prognosis judgement.Methods: The clinical medical records of APIP patients were collected.which were the in-paitents of the first and the second affiliated hospital of Anhui medical university during the period of 2009.1-2016.12.31,Including of the general information and laboratory,imaging indicators et.al.The patients were grouped into HLAP,Biliary AP and Idiopathic AP according to the etiology,the general information and clinical features were analyzed.Then the HLAP patients were divided into 2 groups on whether the secondary abdominal infection occurred.Through analyzed the clinical characteristics to find the influencing factors of abdominal infection.Using SPSS22.0 software for statistical analysis,The qualitative data is tested by the chi-square.the quantitative data expressed in the normal distribution was described with the mean and/or standard deviation,and were tested by T-test.The non-normal distribution data was described with median or rank order,tested by nonparametric test;Single factor analysis was carried out firstely,secondly,the correlation and Logistic regression analysis of these factors which were tested has statistical difference,and the ROC curve was plotted,P<0.05 was considered to be statistically significant.Results:1?There were significant differences in the disease severity,blood calcium,TG and blood glucose,serum albumin in HLAP groups,compared with the patients in other groups of APIP.2?Patients suffered abnominal infection secondary to HLAP seemed more likely to have higher fetal mortality,longer ICU time and higher severity of disease than those without infection.The levels of TG and CRP of infection group were higher.On the other hand,serum calcium and albumin were low,and low calcium last longer;Also,Blood glucose control is relatively difficult;PT and APTT are longer;and the hemoglobin was higher.3?The worst value of breath and pulse in the first 24 hours in hospital and the levels of TG,Blood glucose were proved the prognostic factors dues to the abdominal infection secondary to HLAP.Conclusions:1? HLAP during pregnancy might be characteristiced as : More later in the gestational period,most of the patients suffered severe hyperlipidemia,persistent hypocalcemia,hyperglycemia and hypoalbuminemia.And would be classified as moderate or severe acute pancreatitis,The hospitalization and ICU time last more longer,Organs failure or damage and/or abdominal cavity infection occurred easily.Pregnancy would have be ended in most cases.And the fetal mortality is high.2? The worst values of respiratory and pulse,the levels of TG,serum calcium,albumin,glucose,CRP and the duration of hypocalcemia were the indicators of abdominal infection in pregnant HLAP patients.And the serum values of TG,calcium,albumin,glucose and the duration of hypocalcemia were proved the independent influencing factors.3? To lower the blood lipid,to monitoring the changes of serum calcium,glucose and plasma albumin frequently and do clinical intervention,to assess the severity dynamically might be helpful to reduce the incidence of secondary abdominal infection of pregnant patients,and also to improve the prognosis of the disease. |
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