目的 探討妊娠期并發(fā)急性胰腺炎(APIP)的病因、發(fā)病機(jī)理、臨床特點及防治措施. 方法 對四川省宜賓市第二人民醫(yī)院和四川大學(xué)華西醫(yī)院1995年1月至2006年12月期間收治的72例APIP患者的臨床資料進(jìn)行回顧性分析. 結(jié)果 本組72例中,屬輕型急性胰腺炎(MAP)者49例(68.06%),重癥急性胰腺炎(SAP)者23例(31.94%); 有膽囊炎合并膽囊結(jié)石病史者43例(59.72%),伴高脂血癥者21例(29.17%).采用非手術(shù)治療56例,手術(shù)治療16例,孕婦治愈66例(91.67%),死亡6例(8.33%),死因為多器官功能障礙綜合征、急性呼吸窘迫綜合征及嚴(yán)重復(fù)腔感染; 終止妊娠16例(均為32～38周妊娠),56例繼續(xù)妊娠; 72例中雙胎2例,胎兒死亡共15例(20.27%); 漏診、誤診6例.結(jié)論 APIP的發(fā)生與膽結(jié)石和高脂血癥有關(guān),并于妊娠中晚期發(fā)病率高; 其臨床表現(xiàn)復(fù)雜,易誤診,對孕婦及胎兒威脅極大; 把握該疾病的特點,提高對APIP的認(rèn)識和警惕性,及時準(zhǔn)確的診斷與"個體化"的治療原則,適時終止妊娠,可以提高其治愈率,降低母嬰死亡率.
引用本文： 陳歷恒,蔣曉忠,朱勇,杜一平,嚴(yán)律南,龔光,楊健,李富貴. 妊娠期并發(fā)急性胰腺炎的臨床診治分析. 中國普外基礎(chǔ)與臨床雜志, 2008, 15(1): 58-60. doi: 復(fù)制
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- 1. <>[1]Oría A,Ocampo C,Zandalazini H,et al.Internal drainage of giant acute pseudocysts:the role of video-assisted pancreatic necrosectomy[J].Arch Surg,2000; 135(2)∶136.
- 2. 中華醫(yī)學(xué)會外科學(xué)會胰腺學(xué)組.急性胰腺炎的臨床診斷及分級標(biāo)準(zhǔn)(1996年第二次方案)[J].中華外科雜志,1997; 35(12)∶773.
- 3. Ramin KD,Ramin SM,Richey SD,et al.Acute pancreatitis in pregnancy[J].Am J Obstet Gynecol,1995; 173(1)∶187.
- 4. 高根五.妊娠期急性胰腺炎的診斷治療策略[J].中國普外基礎(chǔ)與臨床雜志,2005; 12(5)∶428.
- 5. Chen CP,Wang KG,Su TH,et al.Acute pancreatitis in pregnancy[J].Acta Obstet Gynecol Scand,1995; 74(8)∶607.
- 6. Yadav D,Pitchumoni CS.Issues in hyperlipidemic pancreatitis[J].J Clin Gastroenterol,2003; 36(1)∶54.
- 7. 吳泓,楊家印.妊娠性急性胰腺炎危險因素分析[J].四川醫(yī)學(xué),2005; 26(3)∶255.
- 8. Ramin KD,Ramsey PS.Disease of the gallbladder and pancreas in pregnancy[J].Obstet Gynecol Clin North Am,2001; 28(3)∶571.
- 9. Tham TC,Vandervoort J,Wong RC,et al.Safety of ERCP during pregnancy[J].Am J Gastroenterol,2003; 98(2)∶308.
- 10. 李德宇.重癥急性胰腺炎手術(shù)指征及療效分析[J].中國普外基礎(chǔ)與臨床雜志,2005; 12(5)∶449.
- 11. Gecelter G,Fahoum B,Gardezi S,et al.Abdominal compartment syndrome in severe acute pancreatitis:an indication for a decompressing laparotomy?[J].Dig Surg,2002; 19(5)∶402.
- 12. Tiwari A,Haq AI,Myint F,et al.Acute compartment syndromes[J].Br J Surg,2002; 89(4)∶397.