怀孕和产后的穿孔性胃:一个系统的审查
Goran Augustin1, Jure Krstulović2,3, Ante Tavra3
1Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia. augustin.goran@gmail.com.
在怀孕期间穿孔性胃潰瘍 (PPU) 很少见,但很危险. 早期干预可以改善胎儿的存活率,尽管孕产妇死亡率仍然很高,特别是在分娩后. 由于症状重叠,诊断是具有挑战性的.
科学领域:
- 产科和妇科 产科和妇科
- 胃肠病学 胃肠病学
- 手术重症监护手术重症监护
背景情况:
- 胃潰瘍疾病 (PUD) 在懷孕期間很少見,穿孔性胃潰瘍 (PPU) 對母親和胎兒造成重大風險.
- 在孕妇或产后患者中诊断PPU是复杂的,因为症状模仿了与怀孕有关的疾病.
- 高的孕产妇和胎儿死亡率与怀孕期间和产后期间的PPU有关.
研究的目的:
- 确定预测孕期PPU早期诊断和治疗的因素.
- 调查PPU诊断与母亲/新生儿结局之间的关联.
- 分析产前和产后PPU病例的死亡率和影响因素.
主要方法:
- 系统审查PubMed,PubMed Central和谷歌学者对于怀孕和产后的PPU病例.
- 包括全文病例报告和系列,提取人口,临床,产科,诊断和治疗数据.
- 按照系统审查和元分析 (PRISMA) 准则的首选报告项目进行分析.
主要成果:
- 收集了43例PPU病例,母亲的平均年龄为30.9岁.
- 在产前期 (55.8%) 比分娩后期 (44.2%) 发生的PPU更频繁,在怀孕后期的发病率上升.
- 常见的症状包括腹部疼痛 (72.1%),腹张 (48.8%). 孕产妇死亡率在第三季度为10%,产后为31.6%,胎儿死亡率为34.8%.
结论:
- 在怀孕或产后期间,大多数PPU病例发生在妊娠的第三季度或产后8天内.
- 早期干预改善了胎儿生存率,但没有影响孕产妇死亡率.
- 孕产妇死亡率独立于诊断方法,穿孔部位,分娩类型,妊娠季度或孕产妇年龄.
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