分娩后不明原因关节痛临床分析  

Clinical analysis of unexplained joint pain after delivery

作　　者：刘伟[1] 王雪卿[2] 宋慧[1] 黄彦弘[1] 王丽芳[1] 颜淑敏[1] 

机构地区：[1]北京积水潭医院风湿免疫科,北京100096 [2]北京积水潭医院妇产科,北京100096

出　　处：《中国妇幼健康研究》2016年第11期1382-1383,1408,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的：分析分娩后不明原因关节疼痛的临床特点及可能的加重病情因素，提高对此类关节痛的认识。方法收集2014年10月至2015年10月在北京积水潭医院风湿免疫科诊治的分娩后不明原因关节痛的临床资料38例，分析其临床特点。结果38例患者年龄在22～40岁，平均（30．20＆#177;4．10）岁，病程半个月～6年，中位数12（3，35）个月，73．68％（28／38）的患者关节痛发生在分娩后前3个月内，与其它时间段相比有显著差异（χ2值分别为34．05、37．30、28．33，均P＜0．05）。76．32％（29／38）的患者关节痛持续时间大于3个月，73．68％（28／38）的患者有下肢负重关节疼痛。多次妊娠（≥2次）患者的关节痛VAS评分、关节疼痛个数均明显高于单次妊娠者（Z＝－2．15、t＝－2．09，均P＜0．05）。既往有流产史的患者关节疼痛个数明显高于无流产史的患者（t＝－1．98，P＜0．05）。结论大部分产妇分娩后不明原因关节痛发生在分娩后前3个月内，大多数有下肢负重关节受累，多次妊娠及既往流产史是加重病情的危险因素。Objective To deepen understanding of postpartum unexplained joint pain by analyzing the clinical characteristics and possible factors of aggravating symptoms of it .Methods Between October 2014 and October 2015, clinical data of patients with postpartum joint pain were collected in department of immunology in Beijing Jishuitan Hospital and the clinical characteristics were analyzed .Results Thirty-eight patients aged 22-40 years old with average age of 30.20＋4.10 years old.Course lasted from half a month to 6 years, and the median was 12 （3, 35） months.There were 73.68%（28/38） patients with joint pain occurring within 3 months after delivery, which was significantly different from other time periods （χ2 value was 34.05, 37.30 and 28.33, respectively, all P〈0.05）.Patients with joint pain longer than 3 months occupied 76.32% （29/38） and 73.68% （28/38） patients had joint pain when lower limbs loaded weight .VAS scores and number of joint pain of patients with multiple pregnancy （ 2 times or more ） were significantly higher than those with single pregnancy （Z=-2.15, t=-2.09, P〈0.05）.The number of joint pain in patients with previous history of abortion was significantly higher than that of patients without abortion （t=-1.98, P〈0.05）.Conclusion Most of joint pain occurs within 3 months after delivery. Most patients have joint pain when lower limbs load .History of multiple pregnancy and previous history of abortion are the risk factors of aggravating disease .

关 键 词：分娩 关节痛 临床特点 加重因素 

分 类 号：R714.1[医药卫生—妇产科学]