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目的总结妊娠合并急性胰腺炎的诊治经验。方法对2004年至2008年收治的12例妊娠合并急性胰腺炎的病因、妊娠时期、临床特点、治疗及预后进行回顾性分析。结果12例妊娠合并急性胰腺炎患者,合并胆囊炎、胆结石4例,高脂血症6例;妊娠20周1例,其余11例均在妊娠28周以上,其中2例孕36周以上。重症急性胰腺炎(SAP)4例,1例妊娠28周早产,产后胎儿短时间内死亡,产后CT见胰周大量渗液;1例妊娠34周胎儿出现宫内窘迫行剖宫产,胎儿存活;另2例SAP治疗22～24d后恢复饮食,1个月后上腹部超声检查均见假性囊肿形成,出院后失访。轻症8例,经治疗48h后腹痛明显减轻,住院1周内血、尿淀粉酶均恢复正常,胎儿检查正常出院。结论积极治疗胆道疾病及控制高脂血症是预防妊娠合并急性胰腺炎的关键,早期诊断及适时终止妊娠可改善孕妇及胎儿的预后。
Objective To summarize the diagnosis and treatment of acute pancreatitis in pregnancy. Methods The etiology, gestational age, clinical features, treatment and prognosis of 12 cases of pregnancy complicated with acute pancreatitis admitted from 2004 to 2008 were analyzed retrospectively. Results 12 cases of pregnancy complicated with acute pancreatitis, cholecystitis, gallstones in 4 cases, 6 cases of hyperlipidemia; 1 case of 20 weeks of pregnancy, the remaining 11 cases were more than 28 weeks of pregnancy, of which 2 cases were 36 weeks pregnant. 4 cases of severe acute pancreatitis (SAP), 1 case of preterm birth of 28 weeks of pregnancy, postpartum fetal death within a short period of time, postpartum CT see a large exudate peritoneal week; 1 case of fetal distress in 34 weeks of pregnancy cesarean section, fetal survival ; The other two SAP patients returned to diet after 22 ~ 24 days. One month later, they were diagnosed as pseudocyst by ultrasonography and disappeared after discharge. Eight cases of mild disease, abdominal pain after 48h treatment significantly reduced, hospital blood, urine amylase returned to normal within 1 week, fetal examination was normal discharge. Conclusion The active treatment of biliary tract diseases and the control of hyperlipidemia are the key to preventing pregnancy complicated with acute pancreatitis. Early diagnosis and timely termination of pregnancy can improve the prognosis of pregnant women and fetuses.