减少误诊、重视妊娠期急性胰腺炎的诊断和治疗  

Misdiagnosis should be reduced and the diagnosis and treatment of acute Pancreatitis in the pragnency period should be attached the importance

作　　者：毕旭东[1] 

机构地区：[1]辽宁医学院附属第一医院普通外科,辽宁锦州121001

出　　处：《中国现代医学杂志》2012年第14期65-68,共4页China Journal of Modern Medicine

摘　　要：目的研究妊娠合并急性胰腺炎的临床特点,分析其治疗原则、注意事项,以及中西医结合治疗的优势。方法回顾性分析过去10年间收治的妊娠期急性胰腺炎病例11例,总结其发病特点、临床表现、治疗方法及结局。全组轻型8例,重型3例。全组11例均采用急性胰腺炎的规范化治疗,其中5例行中西医结合治疗(除常规治疗外,给予中药清胰汤胃管内注入,每日1剂,早晚各1/2剂)。结果 8例轻型7例采用保守治疗,1例因病情反复行剖宫产术,孕妇均治愈;3例重型中2例晚期妊娠保守治疗后病情加重,行剖宫产术,术后行胰腺引流术,1例孕32周,系胆源性胰腺炎,保守治疗好转,1个月后行胆囊切除术,后于外院行引产术。结论妊娠合并急性轻型胰腺炎虽然不是剖宫指征,但保守治疗效果不理想的话,应该终止妊娠;妊娠合并急性重型胰腺炎一般需尽早终止妊娠,中西医结合治疗具有较好的疗效。【Objectives】 To study the clinical characteristics of acute pancreatitis accompanying pregnancy,and explore the treatment principle,attention affairs and the treatment advantages of integrated Traditional Chinese medicine and western medicine.【Results】 There were 8 cases mild pancreatitis and 3 severe type in this group.All the patients adopted acute pancreatitis standardized treatment,among which 5 cases adopted combined treatment of traditional Chinese medicine and Western medicine（except routine therapy,traditional Chinese medicine Qingyi decoction was administered by the way of gastric tube,1 dose every day,morning and evening 1/2 dose respectively）.【Methods】 A retrospective analysis of 11 cases acute pancreatitis in the pregnancy period was made,summary the onset character and clinical menefestation,therapy methods and results.7 cases of mild type acute pancreatitis adopted nonoperation therapy,1 case adopted Cesarean section because of relapse condition,patients were cured.Of 3 severe type acute pancreatitis 2 cases late pregnancy got worse after nonoperation treatment,so adopted Cesarean section,then pancreatic drainage were operated.1 case pregnancied 32 weeks biliary pancreatitis,improved by conservative treatment,1 month later cholecystectomy was operated.Intermediate induced lab or was operated in another hospital after discharge.【Conclusion】 Pregnancy combined with acute pancreatitis was not the indication of caesarean birth,however if conservative treatment did not get the ideal therapy result the pregnancy should be stopped.Pregnancy suffered with severe acute pancreatitis should generally be terminated as soon as possible,the integrated traditional Chinese and western medicine treatment had the better curative effect.

关 键 词：急性胰腺炎 妊娠 治疗 清胰汤 

分 类 号：R657.51[医药卫生—外科学] R714.1[医药卫生—临床医学]