妊娠晚期合并急性胰腺炎患者的手术时机对妊娠结局的影响分析

Analysis of the Impact of Operation Time on the Pregnancy Outcome of Acute Pancreatitis patients in the Third Trimester of Pregnancy

目的:研究妊娠晚期合并急性胰腺炎(APIP)患者的手术时机对妊娠结局的影响。方法:回顾性分析我院2016年7月到2018年6月诊治的35例APIP患者的临床资料,依照不同手术时机分成急诊手术组19例及延期手术组16例。观察和比较两组患者的手术时间、住院时间、下床时间、妊娠结局及并发症的发生情况。结果:急诊手术组的手术时间、住院时间及下床时间均明显短于延期手术组(P<0.05),产妇出现早产、剖宫产、死胎引产的不良结局发生率(15.79%)明显低于延期手术组(50.00%,P<0.05),围产儿发生窒息、畸形、死亡的不良结局发生率(21.05%)显著低于延期手术组(62.50%,P<0.05),产妇的术后并发症发生率(5.26%)明显低于延期手术组(31.25%,P<0.05)。结论:对已确诊的妊娠晚期合并急性胰腺炎患者实施急诊手术能够显著降低妊娠晚期合并急性胰腺炎产妇及其围产儿发生不良结局的可能性,同时有效促进产妇的术后恢复并降低并发症发生率。

Objective： To study the impact of operation time on the pregnancy outcome in acute pancreatitis 35 patients in the third trimester of pregnancy（APIP）. Methods： The diagnosis and treatment of 35 cases with APIP in our hospital from July 2016 to June2018 were retrospectively analyzed. They were divided into the emergency operation group（19 cases）, and the delayed operation group（16 cases） according to different operative timing. The operation time, the time of getting out of bed, hospitalization time, pregnancy outcome and neopathy of the two groups were analyzed and compared. Results： The operation time, time of getting out of bed and hospitalization time of emergency operation group were evidently shorter than those in the delayed operation group（P〈0.05）. The incidence of adverse outcomes of premature delivery, cesarean section and stillbirth induction（15.79 %） was apparently lower in the emergency operation group than that in the delayed operation group（50.00 %, P0.05）. The incidence of asphyxia, deformity and death of perinatal infants in emergency operation group（21.05 %） was visibly lower than that in delayed operation group（62.50 %, P0.05）.The incidence of postoperative complications in the emergency operation group（5.26%） was distinctly lower than that of the delayed operation group（31.25%, P〈0.05）. Conclusion： Emergency surgery for sufferers with acute pancreatitis in the third trimester of pregnancy can prominently reduce the possibility of adverse outcomes in parturients with acute pancreatitis in the third trimester of pregnancy and their perinatal infants, and effectively promote the recovery of postoperatively and reduce the incidence of neopathy complications.