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目的分析妊娠期消化性溃疡患者的临床特征,总结诊治经验。方法回顾性分析19例妊娠期消化性溃疡患者诊治过程。结果患者以节律性腹痛、不同程度反酸、嗳气等为主要症状表现,局限性压痛点89.47%,1例溃疡出血,均给予超声检查,出血者给予纤维内镜检查;1例患者应用氢氧化镁合剂,2例孕早期患者给予中药方剂、2例患者给予西咪替丁、5例患者给予雷尼替丁、10例患者给予胃得乐治疗,出血患者给予输液、输血、抗休克、抗感染与胃大部分切除术治疗;所有患者临床症状均显著改善,择期剖宫产或顺产,未见严重不良妊娠结局,1例产钳助产新生儿轻度窒息,产后11例患者溃疡复发。结论妊娠期消化性溃疡诊断并不困难,据病史、典型临床表现、B超声或内镜辅助检查可确诊,药物治疗疗效较好,但应及早鉴别诊断出血、穿孔。
Objective To analyze the clinical features of patients with peptic ulcer during pregnancy and summarize the experience of diagnosis and treatment. Methods The diagnosis and treatment of 19 patients with peptic ulcer during pregnancy were retrospectively analyzed. Results The patients presented with rhythmic abdominal pain, varying degrees of acid reflux, belching and other symptoms as the main symptoms. The localized tenderness point was 89.47% and the ulcer hemorrhage occurred in 1 patient. All patients were given ultrasound examination and hemorrhage were given endoscopy. One patient was treated with hydrogen peroxide Magnesium mixture, 2 cases of early pregnancy were given prescriptions, two patients given cimetidine, 5 patients given ranitidine, 10 patients given Stapler treatment, bleeding patients given infusion, blood transfusion, anti-shock, anti Infection and gastric resection treatment; all patients were significantly improved clinical symptoms, elective cesarean section or delivery, no serious adverse pregnancy outcomes, 1 case of forceps neonatal mild asphyxia, 11 patients postpartum ulcer recurrence. Conclusions The diagnosis of peptic ulcer in pregnancy is not difficult. According to the history, typical clinical manifestations, B ultrasound or endoscopy assist diagnosis, the curative effect of drug therapy is good, but the diagnosis of hemorrhage and perforation should be done as soon as possible.