妊娠晚期合并结核性渗出性胸膜炎的诊治  

The Diagnosis and Obstetrical Treatment of Pregnancy Complicating Tuberculous Exadative Pleurisy

作　　者：孙红[1] 胡淑君[1] 谭伟坚[1] 

机构地区：[1]广州医学院第一附属医院妇产科,广东广州510120

出　　处：《广州医学院学报》2009年第4期47-50,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨妊娠晚期合并结核性渗出性胸膜炎的诊断与处理方法。方法:回顾性分析3例妊娠晚期合并结核性渗出性胸膜炎的病例资料。结果:3例患者在发病12天以上仍被误诊为其他疾病者2例;均予胸腔穿刺抽液,并给予有效的抗结核药物治疗,胸腔闭式引流1例;并根据孕妇及胎儿情况适时终止妊娠,其中羊水过少合并早产1例,产后出血1例,均预后良好。结论:妊娠期间出现咳嗽、胸痛、消瘦、低热的患者应当考虑有结核感染的可能,即时胸部X线检查。一旦确诊妊娠合并肺结核应尽快给予抗结核药物治疗;若合并结核性渗出性胸膜炎,B超定位下行胸腔穿刺抽液,必要时行胸腔闭式引流;严格掌握继续妊娠指征,适时终止妊娠。Objective：To study diagnosis and treatment of late pregnancy with tuberculous exadative pleurisy. Methods ： Retrospectively analysis 3 cases with late pregnancy and tuberculous exadative pleurisy. Results： 2 cases in 3 patients with onset at 12 days or more are still being misdiagnosed, and drew out fluid by thoracoeentesis, deal with effective anti-tuberculosis medication, one cases is dealed with closed thoracic drainage, according to the situation of pregnant wnmen and fetal, timely termination of pregnancy is needed. One case combined with oligohydramnios premature. One case is postpartum hemorrhage. Prognosis all cases is good. Conclusion： During pregnancy cough, chest pain,weight loss,low-grade fever patients should be taken into account the possibility of have TB infection and an immediate chest X-ray examination should be taken. Once the diagnosis of tuberculosis in pregnancy is definited,Antituberculosis drug should be given as soon as possible; if combined with tuberculous exudative pleurisy,thoracentesis locating with B ultrasonic when necessary., closed thoracic drainage should be taken; Handling strict indications to continue pregnancy, and timely termination of pregnancy.

关 键 词：肺 妊娠晚期 结核 胸膜炎 

分 类 号：R651.15[医药卫生—外科学]