临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2015年
2期
10-13
,共4页
妊娠末期%妊娠并发症%高脂血症%胰腺炎%误诊%阑尾炎%胎盘早剥
妊娠末期%妊娠併髮癥%高脂血癥%胰腺炎%誤診%闌尾炎%胎盤早剝
임신말기%임신병발증%고지혈증%이선염%오진%란미염%태반조박
Pregnancy trimester,third%Pregnancy complication%Hyperlipidemia%Pancreatitis%Diagnostic error%Appendicitis%Abruptio placenta
目的：探讨妊娠晚期合并高脂血症性重症急性胰腺炎( severe acute pancreatitis, SAP)的临床特点和诊治要点。方法对我院1996年9月—2013年9月收治的妊娠晚期合并高脂血症性SAP 14例的临床资料进行回顾性分析。结果本组发病孕周28~34周5例,34~37周7例,37~39周2例；初产妇11例,经产妇3例；均经血脂、血尿淀粉酶、超声及CT检查明确诊断妊娠晚期合并高脂血症性SAP,其中2例首诊误诊为急性阑尾炎,3例因阴道出血疑诊胎盘早剥。14例均行剖宫产术,术后康复出院11例,死亡3例；新生儿死亡3例。结论妊娠晚期合并高脂血症性SAP病情凶险,易致胎儿宫内窘迫,产前控制血脂和早期确诊是获得良好母婴结局的关键。
目的：探討妊娠晚期閤併高脂血癥性重癥急性胰腺炎( severe acute pancreatitis, SAP)的臨床特點和診治要點。方法對我院1996年9月—2013年9月收治的妊娠晚期閤併高脂血癥性SAP 14例的臨床資料進行迴顧性分析。結果本組髮病孕週28~34週5例,34~37週7例,37~39週2例；初產婦11例,經產婦3例；均經血脂、血尿澱粉酶、超聲及CT檢查明確診斷妊娠晚期閤併高脂血癥性SAP,其中2例首診誤診為急性闌尾炎,3例因陰道齣血疑診胎盤早剝。14例均行剖宮產術,術後康複齣院11例,死亡3例；新生兒死亡3例。結論妊娠晚期閤併高脂血癥性SAP病情兇險,易緻胎兒宮內窘迫,產前控製血脂和早期確診是穫得良好母嬰結跼的關鍵。
목적：탐토임신만기합병고지혈증성중증급성이선염( severe acute pancreatitis, SAP)적림상특점화진치요점。방법대아원1996년9월—2013년9월수치적임신만기합병고지혈증성SAP 14례적림상자료진행회고성분석。결과본조발병잉주28~34주5례,34~37주7례,37~39주2례；초산부11례,경산부3례；균경혈지、혈뇨정분매、초성급CT검사명학진단임신만기합병고지혈증성SAP,기중2례수진오진위급성란미염,3례인음도출혈의진태반조박。14례균행부궁산술,술후강복출원11례,사망3례；신생인사망3례。결론임신만기합병고지혈증성SAP병정흉험,역치태인궁내군박,산전공제혈지화조기학진시획득량호모영결국적관건。
Objective To discuss the clinical characteristics and the key points of diagnosis and treatment of late pregnancy merged with hypertriglyceridemia-induced severe acute pancreatitis (SPA). Methods Retrospective analysis on the clinical data of 14 cases of late pregnant women with hyperlipidemia and severe acute pancreatitis was conducted. The pa-tients were admitted to our hospital for treatment during September 1996 and September 2013. Results The onset in the group was at the gestational age of 28 to 34 weeks (5 cases), 34 to 37 weeks (7 cases), 37 to 39 weeks (2 cases) respec-tively. There were 11 cases of unipara and 3 cases of multipara in all the cases, whose diagnoses were confirmed as hypertrig-lyceridemia-induced severe acute pancreatitis following examinations of lipid, blood in the urine amylase, ultrasound and CT. All the patients underwent caesarean section. Among them, 2 cases were first diagnosed as acute appendicitis and 3 cases with vaginal bleeding as suspected placental abruption. Of the 14 cases, there were 11 cases of postoperative rehabilitation and hos-pital discharge, 3 cases of death and 3 cases of neonatal death. Conclusion Late pregnancy merged with hyperlipidemia and severe acute pancreatitis is a dangerous state of illness, prone to cause fetal distress. Prenatal control of blood lipid and early diagnosis are essential for the well-being of both the mother and child.
