体外受精-胚胎移植术后妊娠合并血行播散型肺结核危重病2例报道及文献复习  

Two critical cases of hematogenous disseminated pulmonary tuberculosis during pregnancy after in vitro fertilization-embryo transfer and literature

作　　者：王利艳 李红[2] 高圆圆 高明霞[3] Wang Liyan;Li Hong;Gao Yuanyuan;Gao Mingxia(The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China;Department of Critical Care Medicine,The First Hospital of Lanzhou University,Lanzhou 730000,China;Reproductive Medicine Center,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一医院重症医学科,兰州730000 [3]兰州大学第一医院生殖中心,兰州730000

出　　处：《中国综合临床》2024年第4期302-306,共5页Clinical Medicine of China

基　　金：甘肃省高校科研创新平台重大培育项目(2024CXPT-16)。

摘　　要：妊娠期急性血行播散型肺结核(acute hematogenous pulmonary tuberculosis,AHPTB)合并急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)和脓毒性休克,是一种罕见且致命的状态。现报道的两例患者均因输卵管因素行体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)助孕,妊娠后发生危重AHPTB,随后出现呼吸衰竭。经过辅助呼吸、尽早抗结核以及对症治疗,两例患者病情均好转。对于结核高发地区因输卵管不孕行IVF-ET术后妊娠的女性,出现妊娠期持续发热、咳嗽、咳痰以及阴道出血等症状应警惕结核病的可能,并尽早排查。对于妊娠合并AHPTB的患者,应积极治疗、警惕病情恶化。Acute hematogenous pulmonary tuberculosis(AHPTB)during pregnancy,combined with acute respiratory distress syndrome(ARDS)and septic shock,is a rare and fatal condition.The two reported patients both underwent in vitro fertilization and embryo transfer(IVF-ET)to assist in pregnancy due to tubal factors.They developed critical AHPTB after pregnancy and subsequently developed respiratory failure.After assisted breathing,early anti tuberculosis treatment,and symptomatic treatment,both patients improved their condition.For women who are pregnant after IVF-ET due to tubal infertility in areas with high incidence of tuberculosis,if they have persistent fever,cough,expectoration and vaginal bleeding during pregnancy,they should be alert to the possibility of tuberculosis and be screened as soon as possible.For patients with pregnancy complicated with AHPTB,active treatment and vigilance against worsening of the condition should be taken.

关 键 词：肺结核 急性血行播散型 体外受精-胚胎移植 妊娠 

分 类 号：R714.8[医药卫生—妇产科学] R714.251[医药卫生—临床医学]