Retrospective Clinical Analysis Of 54 Cases Of Acute Pancreatitis During Pregnancy

Purpose: Acute pancreatitis during pregnancy is one of the most serious obstetric diseases.If the diagnosis and treatment are not timely,it can endanger the lives of pregnant women and the fetus.This article retrospectively analyzed the clinical data of 54 patients with APIP treated in our hospital.Through the study of its etiological factors,clinical manifestations and disease progression,laboratory test results,treatment and prognosis,in order to be able to quickly and accurately diagnose APIP.The timely and effective individualized treatment summarizes clinical experience to improve APIP's adverse outcomes.Method: Retrospective analysis of the clinical data of 54 patients with acute pancreatitis during pregnancy in the Department of Obstetrics,Department of Hepatobiliary Surgery,Hepatobiliary Surgery,ICU Department of Surgery,First Clinical Hospital of Jilin University from September 2013 to December 2017,according to the incidence of factors into lipid-derived Factors included 27 cases(50%),biliary factors in 20 cases(37.04%),and unexplained 7 cases(12.96%).According to the severity of acute pancreatitis,the bedside index was divided into mild APIP and severe APIP.Using SPSS 17.0 statistical software,the severity of APIP caused by three groups of pathogenic factors,the differences in clinical manifestations of the three groups of APIP patients,the differences in calcium ions,blood glucose levels of three groups of APIP,blood lipids,hemoglobin,platelets,etc.before and after hemoperfusion.Changes in indicators,the termination of pregnancy,maternal and child outcomes and other aspects of the analysis and summary,resulting in rapid and accurate diagnostic methods and timely and effective treatment options.Result:(1)Incidence of disease: The severity of APIP caused by three different factors(lipogenic,biliogenic,and unexplained)was not the same(P<0.05).Lipid-derived factors and biliary origin were compared between the two groups.Compared with sexual factors,the former is more likely to lead to severe APIP(P <0.05).(2).clinical manifestations: The clinical manifestations of the three groups of mothers are mainly abdominal pain,nausea,vomiting,abdominal distension and other gastrointestinal symptoms,some with threatened abortion,and threatened There were no significant differences in the clinical manifestations of the three groups(P>0.05).Fetal abnormalities mainly manifested as fetal tachycardia(<100bpm);or(> 160bpm),more than 30 minutes,mutation deceleration duration more than 60 seconds,late deceleration,sine wave,fetal heart disappeared,the three groups were compared,in which the lipid source Factors compared with the other two groups,the performance of the fetus is not the same(P <0.05).(3)Laboratory tests: Blood paleozyme,urine amylase,serum lipase,white blood cells,and blood glucose levels all increased in different degrees in patients with lipid-derived,biliary,and unexplained causes,but the three groups compared blood glucose levels.The increase in concentration was not all the same(P<0.05),and the lipid-derived APIP resulted in higher blood glucose concentrations than the other two groups(P<0.05).The serum calcium levels in the three groups of APIP disease were reduced to varying degrees.The serum calcium concentration caused by lipidderived APIP was significantly lower than that in the other two groups(P<0.05);the color Doppler ultrasound of APIP patients showed pancreatic enlargement and pancreas Peripheral fluid accumulation,pancreatic edema showed uniform hypoecho on the color Doppler ultrasound,if there is a thick strong echoes suggest that the pancreas may have hemorrhage,necrosis,three patients with positive performance in 30 cases(55.56%),but the three groups of APIP There was no significant difference in color Doppler positive rate between patients(P>0.05).(4)Treatment: 54 patients were treated with fasting water,spasmolysis,analgesia,and inhibition of contractions.Among them,17 patients with APIP died after termination of pregnancy.Blood perfusion,serum amylase,lipase,cholesterol,triglycerides,high-density lipoprotein,red blood cells,platelets,and hemoglobin decreased significantly after treatment(P<0.05).(5)The method of termination of pregnancy: There was no significant difference in the three groups of APIP delivery methods(P>0.05).(6)There was no significant difference between the three groups of pregnancy outcomes and birth weight and Apgar score of preterm infants and term infants(P>0.05).In conclusion: 1.Lipogenic factors are the primary factors leading to APIP and are more likely to cause severe APIP,and severe APIP termination of pregnancy is mainly cesarean section;2.The fetus of patients with lipogenic gestational acute pancreatitis is more prone to fetal distress,so patients with lipogenic gestational acute pancreatitis should strengthen the monitoring of fetal heart and fetal movement to reduce the occurrence of poor fetal prognosis.3.lipid-derived acute pancreatitis during pregnancy is more prone to hypocalcemia,hyperglycemia,should be closely monitored to prevent ionic disorders caused by hypocalcemia and high blood sugar caused by complications,affect the prognosis;4.Continuous blood perfusion can significantly reduce the concentration of blood amylase,lipase,cholesterol,triglyceride,and high-density lipoprotein,but it also reduces platelet,hemoglobin and other concentrations,so it should be selected according to the needs of the patient or after active intervention.application.