11例妊娠或产褥期重症结核病患者的临床治疗效果分析  

Clinical analysis of 11 patients with severe tuberculosis in pregnancy or puerperium

作　　者：康怡[1] 傅满姣[1] KANG Yi;FU Man-jiao(Department of Severe Tuberculosis,Changsha Pulmonary Hospital,Changsha Central Hospital,Changsha 410004,China)

机构地区：[1]长沙市中心医院长沙市肺科医院结核重症科,410004

出　　处：《中国防痨杂志》2020年第4期385-390,共6页Chinese Journal of Antituberculosis

基　　金：长沙市科技计划项目(kq1801146、kq1801147)。

摘　　要：目的 探讨妊娠或产褥期重症结核病的临床特点和治疗结局.方法 回顾性分析2017年9月至2019年9月长沙市中心医院(长沙市肺科医院)结核重症科收治的11例妊娠或产褥期重症结核病患者,其中妊娠期患者9例,产褥期患者2例,总结其临床特征及母婴治疗转归.结果 早期妊娠患者共2例,均于适当时间终止妊娠;中期妊娠患者共4例,1例继续妊娠并足月分娩,1例于适当时间终止妊娠,1例在治疗过程中流产,1例病情进展迅速,孕妇与胎儿均死亡;晚期妊娠患者共3例,1例坚持妊娠并足月分娩,2例坚持妊娠并早产;成功分娩的6例患者(包括人院前分娩2例,入院后分娩4例)均与新生儿隔离治疗.11例患者均予以积极的抗结核药物及相应的辅助支持治疗,其中10例好转并出院,1例死亡;11例患者共成功分娩6名新生儿,其中足月分娩2名,早产4名,新生儿均无结核感染表现,均未行母乳喂养.结论 妊娠或产褥期重症结核病对母婴健康危害极大,加强对该病临床特点的认识,采取合理的治疗方案,可获得较为理想的治疗效果.Objective To explore the clinical characteristics and treatment outcomes of the patients with severe tuberculosis in pregnancy or puerperium.Methods A retrospective analysis was done among eleven patients who got severe tuberculosis in pregnancy or puerperium(9 cases were in pregnancy while 2 cases were in puerperium)and hospitalized in the Severe Tuberculosis Department of Changsha Central Hospital(Changsha Pulmonary Hospital)from September 2017 to September 2019.The clinical characteristics and the treatment outcomes of those enrolled patients and the situation of infants were analyzed and summarized.Results Two patients were in the early stage of pregnancy and all of them were terminated timely.Four patients were in the mid-term stage of pregnancy,one continued pregnancy and the baby were full-termly delivered;one was terminated timely;one aborted during treatment;and one died(the fetus also died)due to rapid deterioration of her condition.Three patients were in the late stage of pregnancy,one continued pregnancy and the baby were full-termly delivered;the other two continued pregnancy and the babies were prematurely delivered during treatment.Six patients were in puerperium(2 cases delivered before admission and 4 cases delivered after admission)and all of them got treatment and were separated from their newborns.All eleven patients were given active anti-tuberculosis treatment and corresponding supportive treatment,ten of them improved and were discharged from the hospital,one died.Six newborns were delivered successfully in eleven cases,two newborns were full-term while four were premature.All six newborns were not infected tuberculosis and breastfeeding were not given.Conclusion It is extremely harmful to the health of mother and infant when woman gets severe tuberculosis in pregnancy or puerperium.The awareness and understanding to the clinical characteristics of severe tuberculosis in pregnant and puerperal woman should be strengthened.The favorable treatment outcomes can be achieved if proper treatment

关 键 词：妊娠 产褥期疾病 结核 治疗结果 

分 类 号：R714.25[医药卫生—妇产科学]