妊娠并发甲型H1N1流感15例诊治分析  

Clinical analysis of 15 cases of pregnancy complicated with influenza A( H1N1 ) infection

作　　者：吕彦天[1] 陈颖[1] 石宝玉 阮婷[1] 徐国鹏[1] 徐晓[1] 张中伟[1] LV Yan-tian;CHEN Ying;SHI Bao-yu;RUAN Ting;XU Guo-peng;XU Xiao;ZHANG Zhong-wei(Department of Respiratory Medicine,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,JiangSu 215002,China)

机构地区：[1]南京医科大学附属苏州医院,江苏苏州215002

出　　处：《临床肺科杂志》2018年第4期697-700,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的研究妊娠并发甲型H1N1流感的临床特点、治疗方法及妊娠结局。方法对2015年12月至2016年2月苏州市立医院收治15例妊娠期感染H1N1流感的孕妇临床表现、实验室检查、治疗情况进行回顾性分析。结果 15例患者中发热15例,咳嗽14例,咽痛8例,胸痛2例,7例重症及危重症患者出现呼吸困难。15例患者按病情严重程度,轻症8例,重症4例,危重症3例。轻型甲型H1N1流感患者外周血白细胞、淋巴细胞百分比均正常,转氨酶、乳酸脱氢酶、肌酸激酶、白蛋白无明显变化;重症及危重症患者外周血白细胞降低,以T淋巴细胞计数降低明显,转氨酶、乳酸脱氢酶、肌酸激酶增高,白蛋白下降。重症及危重症患者胸部影像显示弥漫性外周为主的渗出性病变。8例轻症患者均治疗后痊愈并足月自然分娩正常新生儿,4例重症患者好转后2例早产2例足月分娩,3例危重患者均行急诊剖宫产术终止妊娠,其中1例胎死宫内,2例足月存活,但有1例孕产妇术后死亡。随访至目前,所有婴儿未有发育异常。结论妊娠并发甲型H1N1流感,轻症患者及时诊断和治疗多可痊愈;对重症及危重症H1N1妊娠患者,死亡率高,及时有效地救治,适时终止妊娠或可改善孕妇病情。Objective To investigate the clinical characteristics,treatment and outcomes of pregnancy complicated with influenza A(H1N1).Methods A retrospective review was done in Suzhou Municipal Hospital from Dec.2015 to Feb.2016,and the clinical manifestations,laboratory examination and treatment of 15 pregnant women complicated with influenza A(H1N1)were recruited.Results For those 15 pregnant women,there were 15 cases of fever,14 cases of cough,8 cases of sore throat,2 cases of chest pain and 7 cases of severe and critically ill patients with dyspnea.15 cases were divided into three groups according to the severity of the disease,including mild disease in 8 cases,severe in 4 cases,and critically disease in 3 cases.The mild type of influenza A showed normal white blood cell and lymphocyte ratio,and there was no marked change of transaminase,lactate dehydrogenase,creatine kinase and albumin.While,for the severe and critically type,white blood cells and lymphocytes proportion decreased(especially T lymphocytes counting dropped),the levels of transaminase,lactate dehydrogenase,creatine kinase increased and albumin decreased.Chest images of severe and critically ill patients showed diffuse peripheral exudative lesions.8 cases of mild patients were cured after treatment and naturally delivered to normal newborns in full term.After 4 cases of severe patients improved,2 cases had premature delivery,and 2 cases were of full term delivery..3 cases of critically ill patients were treated with emergency cesarean section termination of pregnancy,including 1 case of fetal death in utero and 2 cases survived.But there were 1 case of maternal death.Up to now,none of the infants had abnormal growth.Conclusion Pregnant women with mile influenza A H1N1 can be cured with timely diagnosis and treatment.For those severe and critical H1N1 pregnancy patients,the mortality is high,and timely and effective treatment and termination of pregnancy in time can improve the condition of pregnant women.

关 键 词：甲型H1N1流感 妊娠 并发症 妊娠结局 

分 类 号：R714.251[医药卫生—妇产科学]