妊娠合并流行性出血热7例报道  

Epidemic hemorrhagic fever with pregnancy: 7 cases report

作　　者：王英兰[1] 苏放明[1] 魏晓萍[1] 沙文琼[1] 陈文郁[2] 

机构地区：[1]暨南大学附属第二临床医学院,深圳市人民医院妇产科,广东深圳518020 [2]暨南大学附属第二临床医学院,深圳市人民医院感染内科,广东深圳518020

出　　处：《暨南大学学报（自然科学与医学版）》2014年第4期397-400,共4页Journal of Jinan University(Natural Science & Medicine Edition)

基　　金：深圳市科技计划项目(201302027)

摘　　要：目的:研究妊娠合并流行性出血热(EHF)的临床特点及对母婴预后影响,为临床诊治提供参考.方法:总结7例妊娠合并流行性出血热患者的临床资料,对其特征性临床表现、辅助检查及母儿预后情况进行分析.结果:(1)临床表现:6例(85.7%)患者有发热,5例(71.4%)有不同形式的出血.(2)辅助检查:7例患者均出现血小板减少、凝血功能障碍、APTT与TT延长、肝酶升高、低血钾及EHF-IgM抗体阳性.(3)预后情况:孕妇4例痊愈、2例遗留肾功异常、死亡1例.而胎儿-新生儿预后:2例新生儿健康,1例早产儿合并先心病、坏死性小肠炎,3例胚胎-胎儿死亡;1例胎心好孕22周患者失访.结论:妊娠合并EHF母儿病死率均高,主要临床表现为发热、出血,特征性表现为血小板减少、凝血功能障碍、肝酶升高及低血钾,确诊的依据为EHF-IgM阳性.Aim：To study the clinical characteristics of pregnancy combined with epidemic hemorrhag-ic fever （EHF）and the prognosis of the mother and fetus,in order to provide data for clinical diagnosis and therapy of the disease.Methods：7 cases of EHF with pregnancy were analyzed for clinical symp-toms and characteristics.Laboratory tests were carried out for prognosis of the mother and fetus.Results：6 cases exhibited fever symptoms and 5 cases had abnormal bleeding.Laboratory tests showed that all of the 7 cases had thrombocytopenia,coagulation abnormalities,prolonged APTT and TT,elevated activities of liver enzymes,hypokalemia and positive EHF-IgM test.Prognosis：4 of the mothers had fully recov-ered,2 had renal function abnormalities and 1 was dead;2 babies were found healthy,1 premature baby suffered from congenital heart disease and necrotizing enterocolitis,3 fetus were found dead after 7,24, and 27 weeks of gestation,respectively,1 fetus lost contact after 22 weeks of gestation.Conclusion：The mortality is high for both mothers and fetus.Fever and hemorrhage were the main clinical features. Thrombocytopenia,coagulation abnormalities,elevated liver enzyme activities and hypokalemia were the clinical characters of EHF with pregnancy.EHF-IgM is the necessary test for diagnosis.

关 键 词：妊娠 流行性出血热 汉坦病毒 

分 类 号：R714.7[医药卫生—妇产科学]