妊娠合并急性胰腺炎的临床诊治分析

Analysis of clinical diagnosis and treatment foracute pancreatitis in pregnancy

目的探讨妊娠合并急性胰腺炎(APIP)的临床特点、诊断与治疗方法 ,以期提高患者治愈率。方法回顾性分析15例APIP患者的临床资料,根据分级诊断标准将急性胰腺炎(AP)患者分为轻-中度组(6例)和重度组(9例),对两组的实验室及影像学检查结果进行比较分析。结果 15例患者中轻-中度组患者经保守治疗痊愈继续妊娠,重度组患者经基础治疗后行剖宫产终止妊娠,其中1例行引产术。重度组血糖、C-反应蛋白(CRP)升高较轻-中度组显著,差异具有统计学意义(P<0.05)。结论对APIP患者早期诊断、加强对孕期的监护、定期复查相关指标、控制易感因素至关重要,针对每例患者的具体病情综合治疗及采取个体化治疗,适时终止妊娠降低孕妇、胎儿病死率。

Objective To investigate clinical characteristics, diagnosis and treatment measures for acute pancreatitis in pregnancy（APIP）, in order to improve cure rate. Methods Clinical data of 15 APIP patients were retrospectively analyzed. Patients with acute pancreatitis（AP） were divided by classification diagnosis standard into mild-moderate group（6 cases） and severe group（9 cases）. Comparison and analysis were made on laboratory and imageological examination outcomes of the two groups. Results Among the 15 patients, the mild-moderate group was cured by conservativetreatment and had continued pregnancy, while the severe group received cesarean section after basic therapy for pregnancy termination. There was 1 case received induction of labour. The severe group had more obvious increasing of blood glucose and C-reactive protein（CRP） than the mild-moderate group, and the difference had statistical significance（P〈0.05）. Conclusion It is important for APIP patients to receive early diagnosis, enhanced pregnancy monitoring, regularexamination, and predisposing factor controlling. Implement of comprehensive and individual treatment for specific condition of patients, and appropriate pregnancy termination can reduce mortality rate of pregnant women and fetus.