妊娠期急性胰腺炎的诊断和治疗：附48例报告  

The diagnosis and treatment of acute pancreatitis during pregnancy:a report of 48 cases

作　　者：皮健[1] 周萍[2] 解晓宏[1] 黄雄[1] 

机构地区：[1]四川省成都市第二人民医院普通外科,四川成都610017 [2]四川省成都市妇产科医院妇科,四川成都610015

出　　处：《中国普通外科杂志》2009年第3期212-214,共3页China Journal of General Surgery

摘　　要：目的探讨妊娠期急性胰腺炎的临床特点和诊断与处理原则。方法回顾性分析8年收治的妊娠期急性胰腺炎48例的临床资料。38例行非手术治疗(治愈36例);10例手术治疗,手术以清除坏死组织和终止妊娠为主。结果全组以单纯性胰腺炎居多,占64.58%(31/48)。孕妇死亡5例(10.42%),胎儿死亡3例(6.25%),均为重症胰腺炎患者。孕妇合并重症胰腺炎的病死率为29.41%。结论妊娠期急性胰腺炎属于发病率不高,但病死率较高的严重疾患,是妊娠合并外科急腹症死亡的首位因素。该病治疗以非手术治疗为主,病情严重者应及时手术治疗,并不因妊娠而改变手术指征。治疗中同时需顾及孕妇和胎儿的安全。Objective To study the clinical characters, diagnosis and principles of treatment of acute pancreatitis during pregnancy. Methods Forty-eight cases of acute pancreatitis during pregnancy treated in the recent 8 years were retrospectively analyzed, 38 cases had non-surgical treatment （of which 36 cases were cured ） ; 10 cases had surgical treatment to remove necrotic tissue and mainly termination of pregnancy. Results Most of the cases in this group had simple pancreatitis, which accounted for 64.58% （31/48）. There were 5 cases of maternal （10.42% ） death and three cases of fetal （6.25 % ） death, and all were in patients with severe pancreatitis. Fatality rate of pregnant women with severe pancreatitis was 29. 41%. Conclusions Acute panereatitis during pregnancy is a serious disease with low prevalence rate, but has high fatality rate, and is the primary cause of death in acute abdomen of pregnancy. Nonoperative treatment is the first choice of treatment in this condition. In severe cases, timely surgical intervention is warranted, and the surgical indications should not be altered because of the pregnancy. The safety of both the pregnant woman and the fetus must simultaneously be kept into mind during therapy.

关 键 词：胰腺炎/并发症 妊娠 急性病 

分 类 号：R657.51[医药卫生—外科学]