在指导方针和现实之间;怀孕期间急性胆囊炎的复杂决策
Maryam Hassanesfahani1, Brithica Villavarajan2, Ibironke Otusile2
1Flushing Hospital Medical Center, Department of General Surgery, New York, NY, USA. maryam.h.esfahani82@gmail.com.
Langenbeck's archives of surgery
|July 3, 2025
概括
尽管有指导方针,但在怀孕期间胆囊疾病的非手术治疗是常见的. 虽然它导致高复发率,胎儿的结果是有利的,表明需要更新的临床指导方针.
科学领域:
- 产科和妇科 产科和妇科
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
背景情况:
- 胆囊疾病是怀孕期间住院的主要非产科原因.
- 怀孕期间的荷尔蒙变化 (雌激素,孕) 损害了胆囊功能,增加了胆结石的风险.
- 胆汁结肠发作和急性胆囊炎是常见的表现.
研究的目的:
- 为了比较非手术管理 (NOM) 与孕妇胆囊疾病的手术干预的结果.
- 评估治疗组之间的母胎并发症和复发率.
主要方法:
- 对228名患有胆囊疾病的孕妇患者的回顾性评估 (2012年10月至2022年12月).
- 数据包括患者人口统计,临床表现,诊断,治疗和结果.
- 菲舍尔的精确测试用于统计分析.
主要成果:
- 八名患者因失败的NOM而接受了手术管理 (OM);没有并发症.
- 220名患者接受了保守的 (NOM) 管理,其中77%的人经历了复发.
- 在这两组中都没有观察到母胎并发症;NOM的再入院率更高.
结论:
- 在临床实践中,对于患有胆囊疾病的孕妇患者,非手术治疗很普遍.
- NOM与高症状复发和产后再入院有关,但显示出有利的胎儿结果.
- 需要更新指南,以反映当前的做法,并促进个性化的患者护理.
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