妊娠期胆石症的治疗策略

Therapeutic Strategies of Gestational Cholelithiasis

妊娠期胆石症是妊娠期常见的非产科疾病。有症状的妊娠期胆石症不仅危害母体健康,还威胁胎儿的健康发育和生存。既往妊娠期胆石症通常不采用手术治疗,认为妊娠期胆石症手术可能增加新生儿低体重的发生率,但妊娠期胆石症保守治疗的失败率较高,且疗效较短暂,复发率亦较高。随着手术及麻醉技术的进步,妊娠期已不是胆石症手术的禁忌。与保守治疗相比,手术治疗妊娠期胆石症的效果更好,可有效降低产科并发症发生率以及胎儿引产率、早产率和死亡率。目前对妊娠期胆石症的研究均为样本量较小的回顾性研究,仍需大样本随机对照试验以明确其最佳治疗方式。

Cholelithiasis during pregnancy is a common non-obstetric disease.Symptomatic cholelithiasis during pregnancy not only endangers the health of the mother,but also threatens the healthy development and survival of the fetus.In the past,it was usually not treated by surgery,because it was considered that the surgery may increase the incidence of low birth weight,but the failure rate of conservative treatment was high,and the curative effect was short,and the recurrence rate was also high.With the development of surgery and anesthesia technology,pregnancy is no longer the contraindication of cholelithiasis surgery.Compared with conservative treatment,surgical treatment of cholelithiasis in pregnancy is more effective,which can effectively reduce obstetric complications and the rate of induced labor,premature delivery and mortality.At present,the studies of cholelithiasis in pregnancy are mostly retrospective studies with a small sample size,and large-sample randomized controlled trials are still needed to determine the optimum treatment.