摘要
目的探讨妊娠期并发急性胰腺炎的病因、发病机制、临床特点及治疗措施。方法回顾性分析瑞金医院2003年1月～2012年10月收治的36例APIP患者的临床资料。结果本组36例患者中,属轻型急性胰腺炎者20例(55.56%),重症急性胰腺炎者16例(44.45%);大部分SAP发生在妊娠晚期。高脂血是导致SAP的主要因素,胆道疾病则是MAP的主要诱因。采用非手术治疗28例(77.78%),手术治疗8例(22.22%)。妊娠早期和中期终止妊娠10例,继续妊娠至妊娠晚期26例,其中胎儿死亡2例。漏诊、误诊3例。结论 APIP的发生主要与胆结石和高脂血症有关,妊娠中晚期发病率高,对于重症患者可发生胎儿宫内死亡的严重并发症。对于MAP的患者,保守治疗为首选方案。在治疗胰腺炎的同时,SAP的患者宜尽早终止妊娠。
Objective This paper investigated the etiology, pathogenesis and treatment strategies of acute pancreatitis in pregnancy. Methods Medical records of 36 patients in our hospital were reviewed for every pregnant woman with acute pancreatitis during Jan.2003 to Oct.2012. Results 20 patients with mild acute pancreatitis （55.6%）, 16 patients with severe pancreatitis （44.5%）. Gestational age of onset was significantly higher in the severe acute pancreatitis group than in the mild acute pancreatitis group. Severe hypertriglyceridemia was considered the main cause of SAP, however biliary duct disease contributed to the etiology of MAP. 28 of these patients received conventional therapy （77.8%）.10 patients received operation （22.2%）.10 patients got induced abortion at early and midterm of pregnancy, Rest of 26 patients continued pregnancy to third trimester. 2 cases had fetal death. There were 3 misdiagnosed cases.Conclusion Biliary pancreatitis and hyperlipidemia pancreatitis are the main causes of APIP,respectively.Acute pancreatitis in pregnancy usually occurs in the third trimester,and the affected severe patients are more liable to develop a critical condition that results in higher risk of intrauterine fetal death.The first choice of MAP in pregnancy is the conventional therapy. Apart from the conventional therapy,we need to terminate pregnancy as early as possible for patients with SAP.
出处
《中国医药科学》
2013年第4期17-19,共3页
China Medicine And Pharmacy
关键词
妊娠并发症
剖宫产
胰腺炎
产后出血
诊断
治疗
Pregnancy complications
Cesarean section
Postpartum hemorrhage
Pancreatitis
Diagnosis
Treatment
