摘要
目的探讨晚期妊娠合并重症急性胰腺炎(SAP)的处理方法。方法回顾性分析2016年1月至2022年8月安徽医科大学第一附属医院收治的22例晚期妊娠合并急性胰腺炎患者的临床资料。结果8例足月妊娠患者入院后立即行剖宫产,1例孕31周人院时死胎患者因多器官功能障碍转人EICU。经药物对症治疗后自行娩出胎儿及胎盘。13例在72小时内恶化为严重胰腺炎,在充分沟通后,产科予以行紧急剖宫产手术;新生儿出生后直接收住NICU病房,无死胎。孕妇在术后转人ICU过渡治疗后平均住院时间(1~15天);所有患者均无死亡,胰腺炎均在2周内改善。结论保守治疗对大多数晚期妊娠合并急性胰腺炎的患者具有一定效果;同时,应密切监测母亲和胎儿的情况,一旦症状加重或胎儿生命受到威胁应该终止妊娠。
To investigate the management of severe acute pancreatitis(SAP)occurring in late pregnancy.Methods The clinical data of 22 patients with SAP in late pregnancy treated in the First Affiliated Hospital of Anhui Medical University during January 2016 to August 2022 were analyzed retrospectively.Results 2 patients of full-term pregnancy underwent cesarean section immediatelyafter admission,and 1 patient carrying a dead fetusat 30 weeks gestation was transferred to EICU due to multiple organ dysfunction.The fetus and placenta were delivered by herself after symptomatic treatment with drugs.18 cases worsened to severe pancreatitis within 72 hours,and emergency cesarean section was performed in the obstetric department after adequate communication.At the same time,the newborn was admitted to the NICU ward directly after delivery,without fetal death.The average length of stay in ICU after transfer to ICU for transition treatment(1~15 days);One case improved after conservative treatment,and the fetus was delivered to obstetrics and gynecology section after full term.No death occurred in all patients,and pancreatitis improved within 2 weeks.Conclusion Conservative treatment is effective in most women complicated with SAP during late pregnancy.Meanwhile,the conditions in both mother and fetus should be monitored closely,Once symptoms worsen or a fetal life is at riskpregnancy termination should be performed.
作者
程炯炯
王兴宇
张剑林
赵浩东
陈卫东
胡志旭
CHENG Jiong-jiong;WANG Xing-yu;ZHAO Hao-dong(The First Hospital of Anhui Medical University,Hefei 230022,China)
出处
《肝胆外科杂志》
2023年第3期193-195,共3页
Journal of Hepatobiliary Surgery
关键词
晚期妊娠
急性胰腺炎
多学科治疗
late pregnancyacute
pancreatitis
multi-disciplinary treatment(MDT)
