克罗恩病合并妊娠并发肠皮瘘1例  

Crohn's disease complicated by enterocutaneous fistula during pregnancy:a case report

作　　者：陈芳芳 黄健[1] Chen Fangfang;Huang Jian(Department of Obstetrics,the Second Xiangya Hospital of Central South University,Changsha 410000,China)

机构地区：[1]中南大学湘雅二医院产科,长沙410000

出　　处：《中华围产医学杂志》2024年第12期1080-1082,共3页Chinese Journal of Perinatal Medicine

摘　　要：本文报告1例克罗恩病合并妊娠并发肠皮瘘孕妇的诊疗经过及妊娠结局。患者本次妊娠前5个月于中南大学湘雅二医院诊断克罗恩病,本次妊娠未规律产前检查,英夫利西单抗维持治疗至孕18周自行停药。孕26周时原2015年阑尾手术切口出现疼痛,外院抗炎治疗无明显好转;孕36周右侧腹壁肌层出现液性暗区,予引流、清创等处理;孕37周发现肠皮瘘。遂于2023年10月6日(孕37周+1)转入中南大学湘雅二医院,在多学科团队协作下于孕37周+5剖宫产手术同时行肠切除吻合术。术后随访8个月,母儿结局良好。This article reported the diagnosis,treatment,and pregnancy outcome of a woman with Crohn's disease complicated by enterocutaneous fistula during pregnancy.The patient was diagnosed with Crohn's disease at the Second Xiangya Hospital of Central South University five months ago.In this pregnancy,there was no regular prenatal examination,and maintained on infliximab treatment until she discontinued the medication at 18 weeks of gestation.At 26 weeks of gestation,she experienced pain at the incision site of a previous appendectomy performed in 2015 and showed no sign of improvement following an anti-inflammatory treatment in another hospital.At 36 weeks of gestation,an opaque dark area of fluid appeared in the right abdominal wall muscle layer of the patient,which was managed with drainage and debridement.At 37 weeks of gestation,the patient developed enterocutaneous fistula.On October 6,2023(37+1 weeks of gestation),she was transferred to the Second Xiangya Hospital of Central South University.Under the collaboration of a multidisciplinary team,a cesarean section together with bowel resection and anastomosis was performed at 37+1 weeks of gestation.The maternal and neonatal outcomes were good during an eight-month follow-up after the surgery.

关 键 词：肠皮瘘 克罗恩病 妊娠结局 

分 类 号：R714.255[医药卫生—妇产科学]