摘要
目的探讨妊娠合并重症急性胰腺炎(SAP)的临床特点及高容量血液滤过(high volume hemofiltration,HVHF)治疗的作用。方法将我院6例患者和文献检索的66例患者分为A、B两组,观察患者发病时孕龄、孕周、诱因、病因、临床表现、生化指标、治疗结果及预后。A组在传统治疗基础上,加用HVHF治疗;B组对照。结果A组6例孕周均>34周,HVHF治疗前血淀粉酶529.71±76.53U/L,治疗后血淀粉酶83.69±33.67U/L。孕产妇均存活,围产儿病死率33.33%(2/6)。B组孕产妇病死率19.70%(13/66),围产儿病死率27.27%(18/66)。结论>34周SAP终止妊娠手术治疗为主,加用HVHF治疗,可降低SAP孕产妇死亡。<34周SAP内科保守及内镜治疗为基本治疗。控制血脂及胆道疾病发作,合理饮食,对预防本病具有重要意义。
Objective To analyse the clinical feature and the effect of high volume hemofihration（HVHF）on the severe acute pancreatitis（SAP）during pregnancy. Methods 6 cases from our hospital and 66 cases from published papers were divided into two groups as A and B. The gestational age, gestational week, contributing factors, pathological causes, clinical presentation, biochemical parameters ,therapeutic outcome and prognosis were evaluated. Group A were treated with HVHF on the basis of traditional therapy. Group B served as control. Results Groups A 6 cases over 34 gestational weeks, the hemodiastase decreased obviously after the hemofiltration,from（529.71±76.53）U/L dropped to（83.69±33.67） U/L. In group A six pregnant women were survived, two infant were dead. In group B, the mortality rate during pregnancy was 19%（ 13/66）for the pregnant women, and 27%（ 18/66 ）for the fetuses. Conclusions Termination of pregnancy surgical are main treatment for pregnancy over 34 gestational week. Combined with the high volume hemofiltration can lower the mortality of acute pancreatitis of pregnancy. However, conservative medical therapy is the basic method for less 34 gestational weeks＇ women. Controlling BMI and serum triglyceride and treating hiliary diseases are important in preventing SAP during pregnancy.
出处
《中华保健医学杂志》
2008年第3期189-191,共3页
Chinese Journal of Health Care and Medicine
关键词
妊娠并发症
急性胰腺炎
临床分析
Pregnancy complications
Acute pancreatitis
Clinical analysis
