妊娠合并严重神经内科疾病10例临床分析  

Clinical Analysis of 10 Cases with Pregnancy Accompanied with Encephalopathy

作　　者：邢风玲[1] 冯力民[1] 贾晓芳[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科

出　　处：《首都医科大学学报》2006年第2期261-262,共2页Journal of Capital Medical University

基　　金：首都医学发展科研基金(2002-1002)资助项目

摘　　要：目的研究妊娠合并神经内科疾病的临床特点、治疗方法及对胎儿影响。方法对1990年1月至2005年5月收治的10例妊娠合并神经内科疾病患者的临床资料进行回顾性分析。结果妊娠合并癫痫4例,妊娠合并脑梗死4例,垂体瘤术后1年1例,大脑多发性硬化1例。10例患者全部存活;新生儿10例,存活7例,死亡3例(胎死宫内1例,脑积水及脊柱裂各1例)。结论妊娠合并癫痫患者宜减药至最低维持剂量(标准:有小发作或不发作),而不应一味停药,以防出现癫痫持续状态,危及母婴安全。为预防胎儿神经管畸形,可加用叶酸治疗,产前1月宜用维生素K1,以防止新生儿出血。癫痫持续状态患者宜采用剖宫产分娩。加强产前检查,早期及时发现妊娠高血压综合征是防止患者发生脑梗死的关键。Objective To investigate the clinical characteristics, early diagnosis, preventive therapeutic methods, and the effects on maternal and infant health of encephalopathy during pregnancy. Methods The clinical manifestations of 10 cases with pregnancy accompanied with encephalopathy in Tiantan hospital from Jan. 1990 to Mar. 2005 were analysed retrospectively. Results Pregnancy could accelerate the growth or rupture of cerebroma and encephalic angioma. Craniotomy was necessary as soon as possible. Caesarean section was the suitable delivery modus. We focused in prevention and treatment of post-eclampsia cerebral infarction. The cases of epilepsy during pregnancy should take medicine properly according to pathogenetic condition. Conclusion The high rate of misdiagnosis, quick development and high rate of death account for characteristics of encephalopathy during pregnancy. Regular antenatal examination, early diagnosis and just-in-time treatment are critical to improve the prognosis.

关 键 词：妊娠 脑梗死 癫痫 

分 类 号：R714.25[医药卫生—妇产科学]