妊娠合并急性胰腺炎16例诊治经验

Diagnosis and treatment of pregnancy with acute pancreatitis : an experience of 16 case

目的增加对妊娠合并急性胰腺炎的认识,探讨其临床特点、治疗原则、预防措施以及其对孕产妇和胎儿的影响结果。方法回顾性分析16例妊娠合并急性胰腺炎的临床特点、治疗方法及结局。结果 13例轻型胰腺炎患者采用保守治疗,无一例因胰腺炎行剖宫产术,母婴均安全出院,3例重症胰腺炎患者保守治疗加用连续肾脏替代治疗后病情无明显好转,及时行剖宫产术,孕妇均治愈。结论妊娠合并急性胰腺炎的主要诱因是胆管疾病和高脂血症;诊断主要依据影像学检查;治疗轻型胰腺炎可以行保守治疗;重症胰腺炎在保守治疗基础上应果断终止妊娠并进行胰周引流术。

Objective To report the experience in treating pregnancy with acute pancreatitis（APIP）, discuss the clinical characteristics, treatment principles and prevention measures and their effects on maternal and fetal outcome. Methods Sixteen cases of APIP who submitted in our hospital between Jan 2006 and Jun 2014 were retrospectively analyzed clinical characteristics, treatment and outcome. Results All pregnant women were cured. Thirteen cases with mild acute pancreatitis were treated by conservative treatment, no cesarean section due to pancreatitis, maternal and child are safe discharge. Three cases of severe acute pancreatitis were failed to conservative treatment and continuous renal replacement therapy,and emergency cesarean was performed. Conclusion Among these patients,bile duct disease and hyperlipidemia were the main cause of APIP. Diagnosis was mainly depended on imaging examination.Conservative treatment was effective to mild acute pancreatitis,while severe acute pancreatitis after conservative treatment should be determined on the basis of termination of pregnancy and peripancreatic drainage.