妊娠首发系统性红斑狼疮误诊为肠梗阻两例分析  

Pregnancy Complicated with Systemic Lupus Erythematosus Misdiagnosed as Intestinal Obstruction:Analysis of 2 Cases

作　　者：李洁[1] 石满华[1] 

机构地区：[1]中南大学湘雅医院急诊科,湖南省长沙市410008

出　　处：《中国全科医学》2010年第2期176-177,共2页Chinese General Practice

摘　　要：目的总结以肠梗阻为首发症状的妊娠首发系统性红斑狼疮(SLE)患者的临床特点,提高对此病的认识,降低误诊率。方法对2例误诊为肠梗阻的SLE患者的临床资料进行回顾性分析。结果误诊的2例患者中1例妊娠17周,因腹痛、腹胀、呕吐1周,肛门停止排气4d就诊;1例妊娠16周,因腹痛、腹胀、呕吐、肝门停止排气5d就诊,均误诊为机械性肠梗阻,行剖腹探查术,术后均因宫内死胎终止妊娠。给予大剂量激素治疗后病情均缓解。结论妊娠首发SLE且以肠梗阻为首发症状者不多见,极易出现误诊误治,临床应避免不必要的手术,最大限度地降低误诊率。Objective To investigate the clinical features of pregnancy complicated with systemic lupus erythematosus （SLE） with intestinal obstruction （IO） as first symptom. Methods A retrospective analysis was carried out on clinical data of 2 pregnant SLE women with IO as first symptom. Results Of 2 pregnant women with SLE, 1 with 17 - week pregnancy sought medical advice due to abdominal pain and distension, vomiting （for 1 week）, no hepatic portal exhaust （for 4 d）, 1 with 16 - week pregnancy due to abdominal pain and distension, vomiting, no hepatic portal exhaust （ for 5 d）. Both were misdiagnosed as mechanical intestinal obstruction and received surgical intervention, and pregnancy terminated because of intrauterine stillbirth after surgery. High - dose methylprednisolone therapy improved the symptoms. Conclusion Pregnancy with SLE with IO as first symptom is rare, prone to misdiagnoses and mistreatments. Unnecessary surgeries should be avoided to minimize the rate misdi- agnoses.

关 键 词：妊娠 红斑狼疮 系统性 肠梗阻 误诊 

分 类 号：R593.24[医药卫生—内科学]