摘要
Abstract
Objective To explore features of clinical manifestation, diagnosis and management of acute pancreatitis (AP) in pregnancy. Methods Medical records of 19 patients with AP in pregnancy admitted to the Obstetrics and Gynecology of No. 6 Peoples Hospital Affiliated to Shanghai Jiao Tong University between Nov. 2007 and Nov. 2010 were studied retrospectively. Results Among the 19 patients, mild acute pancreatitis (MAP) occurred in 11 cases (57. 9% ) , while severe acute pancreatitis (SAP) occurred in the rest 8 cases (42. 1% ). Pathogenic risk factors mainly were gallbladder and/or biliary tract stones (4 cases) and hyperlipidemia(4 cases). Nineteen (100% ) presented with acute abdominal pain, 18 (94. 5%) with nausea and vomiting. Fever (4 cases, 21. 1% ) , abdominal distension (8 cases, 42. 1% ) , and unstable respiratory and circulatory function(8 cases, 42. 1% )accompanied were strong indications for SAP. Eighteen cases (94. 5% ) had elevation of the plasma and/or urine concentration of amylase. Five cases (26. 3% ) were diagnosed by color sonography and 8(42. 1% ) by MRI or CT after color sonography. One case had a delay in diagnosis. Positive conservative treatment was taken in most of the cases (15 cases, 78. 9% ) with a favorable outcome. Five cases (26. 3% ) of critically ill patients were monitored in ICU, and 4 patients underwent surgical interventions. As a result, all of the 19 patients had better prognosis. No maternal death was observed. There were 7 preterm labors and 2 fetal losses, accounting for the perinatal mortality of 10. 5%. Conclusion While a pregnant woman suffered acute abdominal pain, early diagnosis and illness severity assessment of AP is very important. Active conservative treatment with intensive care is recommended. Surgical intervention should be performed as late as possible.关键词
急性胰腺炎/妊娠/疾病治疗Key words
acute pancreatitis/ pregnancy/ disease management分类
医药卫生
