急性胰胆道疾病孕妇个体化内镜治疗

Ping Huang, H. Zhang, Xiao-feng Zhang, Xiao Zhang, W. Lv
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引用次数: 1

摘要

背景:急性胰胆道疾病是较为普遍的,往往可导致严重的孕产妇和胎儿的发病率和死亡率在妊娠期。早期解除胆道梗阻非常重要。目的:评价个体化内镜治疗妊娠期急性胰胆道疾病的安全性和有效性。背景与设计:本研究为单中心回顾性研究。材料与方法:回顾性分析2012年1月至2016年1月86例经个体化内镜治疗的急性胰胆道疾病孕妇的临床资料。主要观察手术成功率、首次内镜治疗后1周实验室指标恢复情况、并发症、预后、住院时间、不同妊娠期个体化内镜治疗的不同效果。使用统计分析:使用SPSS 13.0版统计软件对数据进行分析。采用描述性统计。结果:所有患者手术成功率97.67%(84/86)。患者术后腹痛、发热等临床症状迅速改善。第一次内镜治疗后1周实验室指标明显改善(P < 0.05)。并发症分别为胆道出血2例,急性胆管炎1例,内镜后逆行胆管胰管造影胰腺炎2例,高淀粉酶血症2例。并发症发生率为8.14%(7/86)。患者平均住院时间16.02±4.32 d。不同妊娠期内镜治疗效果比较,差异无统计学意义(P < 0.05)。结论:对妊娠期急性胰胆道疾病患者进行个体化内镜治疗,安全性好、疗效显著、并发症少,应由经验丰富的操作者操作。
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Individualized endoscopic treatment for pregnant patients with acute pancreaticobiliary diseases
Background: Acute pancreaticobiliary diseases are more prevalent and can often lead to severe maternal and fetal morbidity and mortality during pregnancy period. It is very important that early relieving biliary obstruction. Aims: To evaluate the safety and efficacy of individualized endoscopic treatment in managing acute pancreaticobiliary diseases in pregnant patients. Settings and Design: It is a single-center, retrospective study. Materials and Methods: Clinical data of 86 pregnant women with acute pancreaticobiliary diseases treated using individualized endoscopic treatment from January 2012 to January 2016 were analyzed retrospectively. The primary observed indicators included the operation success rate, recovery of laboratory indicators 1 week after the first endoscopic treatment, complications, prognosis, hospital stay, and different effect of individualized endoscopic therapy during different pregnancy period. Statistical Analysis Used: Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 13.0 statistical software. Descriptive statistics was used. Results: The operation success rate was 97.67% (84/86) in all patients. Postoperative abdominal pain, fever, and other clinical symptoms were improved rapidly in patients. The laboratory indicators 1 week after the first endoscopic treatment were improved significantly (P < 0.05). The complications included biliary bleeding, acute cholangitis, postendoscopic retrograde cholangiopancreatography pancreatitis, and hyperamylasemia in 2, 1, 2, and 2 cases, respectively. The complication rate was 8.14% (7/86). The mean hospital stay of patients was 16.02 ± 4.32 days. Moreover, there was not statistically significant difference in the effect of endoscopic therapy during different pregnancy period (P > 0.05). Conclusions: Due to the good safety, marked effect, and little complications, individualized endoscopic treatment should be preferred therapy for patients with acute pancreaticobiliary diseases during pregnancy when performed by experienced hands.
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