妊娠合并急性胰腺炎16例病例分析

Analysis of 16 cases of acute pancreatitis in pregnancy

摘要:

目的：探讨分析妊娠合并急性胰腺炎疾病的临床表现、病因及其治疗方法。方法：入选2010年1月至2016年12月期间安徽省立医院收治的16例妊娠合并急性胰腺炎患者，观察患者的临床特征、生化检测及B超和CT的结果，记录患者治疗过程及预后，并对照同期入院的16例非急性胰腺炎产妇做回顾分析。结果：14例患者为轻型急性胰腺炎患者，2例为重型，11例患者获得活婴。14例轻型患者中9例胎儿已足月，8例行剖宫产术，1例进行产钳助娩；5例轻型患者胎儿孕周较小，经保守治疗后好转出院；2例重型患者剖宫产终止妊娠并经内科对症治疗后出院。结论：妊娠合并急性胰腺炎的主要病因为胆管疾病和高脂血症；血、尿淀粉酶及影像学检查是该类疾病诊断的重要依据；治疗过程中应充分考虑病人的生命安全，同时结合患者疾病特征，制定个体化治疗方法。

Abstract:

Objective：To explore the clinical features，etiology，diagnosis and treatment of acute pancreatitis in pregnancy. Methods：From January 2010 to December 2016，16 patients with acute pancreatitis were enrolled in this study，and the data of clinical fea－tures，biochemical examination，B-mode ultrasound，computed tomography，therapeutic process and prognosis were retrospectively analyzed. Results：Fourteen cases were diagnosed as mild acute pancreatitis and 2 were as severe acute pancreatitis patients. Eleven of the total 16 patients had maternal live babies. In patients with mild acute pancreatitis，9 cases had fetal maturity（8 had cesarean section termination，1 had vaginal delivery）. For the other 5 cases whose gestational age were smaller，the disease symptoms were improved after conservative treatment. Two patients with severe acute pancreatitis who had hyperlipidemia ended pregnancy by cesarean section and were treated by internal medicine and discharged from hospital. Conclusion：The main pathogeny of pregnancy complicated acute pancreatitis are bile duct disease and hyperlipidemia. Blood，urine amylase and imaging examination are commonly used clinical examination at current. On the base of patients’ safety，individualized therapy should be adopted according to their clinical feature.