Clinical Analysis of Diagnosis and Treatment of Acute Pancreatitis in Pregnancy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

陈历恒 ¹ , 蒋晓忠 ¹ , 朱勇 ¹ , 杜一平 ¹ , 严律南 ² , 龚光 ² , 杨健 ¹ , 李富贵 ²

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Keywords：

妊娠并发症,　胰腺炎,　诊断,　　治疗

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目的探讨妊娠期并发急性胰腺炎(APIP)的病因、发病机理、临床特点及防治措施. 方法对四川省宜宾市第二人民医院和四川大学华西医院1995年1月至2006年12月期间收治的72例APIP患者的临床资料进行回顾性分析. 结果本组72例中,属轻型急性胰腺炎(MAP)者49例(68.06%),重症急性胰腺炎(SAP)者23例(31.94%); 有胆囊炎合并胆囊结石病史者43例(59.72%),伴高脂血症者21例(29.17%).采用非手术治疗56例,手术治疗16例,孕妇治愈66例(91.67%),死亡6例(8.33%),死因为多器官功能障碍综合征、急性呼吸窘迫综合征及严重复腔感染; 终止妊娠16例(均为32～38周妊娠),56例继续妊娠; 72例中双胎2例,胎儿死亡共15例(20.27%); 漏诊、误诊6例.结论 APIP的发生与胆结石和高脂血症有关,并于妊娠中晚期发病率高; 其临床表现复杂,易误诊,对孕妇及胎儿威胁极大; 把握该疾病的特点,提高对APIP的认识和警惕性,及时准确的诊断与"个体化"的治疗原则,适时终止妊娠,可以提高其治愈率,降低母婴死亡率.

Citation： 陈历恒,蒋晓忠,朱勇,杜一平,严律南,龚光,杨健,李富贵. Clinical Analysis of Diagnosis and Treatment of Acute Pancreatitis in Pregnancy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(1): 58-60. doi: Copy

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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. 中华医学会外科学会胰腺学组.急性胰腺炎的临床诊断及分级标准(1996年第二次方案)[J].中华外科杂志,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诊断治疗策略[J].中国普外基础与临床杂志,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. 吴泓,杨家印.妊娠性急性胰腺炎危险因素分析[J].四川医学,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.重症急性胰腺炎手术指征及疗效分析[J].中国普外基础与临床杂志,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.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Analysis of Diagnosis and Treatment of Acute Pancreatitis in Pregnancy

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