探讨妊娠合并急性胰腺炎（APIP）的病因、发病机制、临床特点及诊治方法。

回顾性分析2001年1月至2013年12月中山大学附属第一医院22例（25例次）APIP患者的临床资料，其中早期妊娠2例次，中期妊娠7例次，晚期妊娠16例次；轻型急性胰腺炎20例次，重症急性胰腺炎5例次。

22例（25例次）APIP患者中，合并胆道疾病9例，合并高脂血症5例，同时合并胆道疾病及高脂血症1例。全部患者均有不同程度腹痛及血清淀粉酶、尿淀粉酶升高。超声提示符合胰腺炎声像10例次。患者均先予以保守治疗，1例腹膜炎严重者予以手术清创引流，术后多次血浆置换；1例先天性胆管囊性扩张症患者行经皮经肝胆管置管引流术。患者无死亡，共19例中止妊娠，胎儿早产4例（21.1%），死亡5例（26.3%）。

APIP好发于妊娠中、晚期，胆道疾病及高脂血症是主要病因。该病的临床表现往往不典型，淀粉酶检测十分必要。治疗上以保守治疗为主，但胰腺感染坏死严重时也应及时外科干预，符合条件时应及时中止妊娠。

To explore the etiology, pathogenesis, clinical characteristics and diagnosis and treatment of acute pancreatitis in pregnancy (APIP).

A retrospective review of the clinical data of twenty two APIP women admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2001 to December 2013 was carried out, presenting with 25 episodes of acute pancreatitis. 2 attacks occurred in the first trimester, 7 in the second trimester, and 16 occurred in the third trimester. 20 episodes were classified as mild acute pancreatitis, and 5 as severely acute pancreatitis.

Nine patients had biliary pancreatitis, 5 had hyperlipidemia, and 1 patient had both biliary disease and hyperlipidemia. Abdominal pain and increased amylase appeared in all of the patients. Ten patients were identified as acute pancreatitis by B type ultrasonography. All patients were treated conservatively after admission. One patient with severe pancreatitis underwent surgery and was transferred serum postoperatively, and 1 with congenital cystic dilatation of bile duct underwent percutaneous transhepatic cholangial drainage. Pregnancy was terminated in 19 patients. There were 4 cases with preterm labor, 5 with fetal losses, and no maternal death.

Most attacks occur in the second and third trimester. Biliary diseases and hyperlipidemia are the most common causes of APIP. The clinical manifestation of APIP is not characteristic, and the test of amylase is necessary. Conservative treatment is the first choice, but operation should be taken for patients with operation indications. Terminating pregnancy in time is very important.