摘要
目的讨妊娠晚期合并重症新型甲型H1N1流感(简称甲型流感)患者的临床特征及治疗方法。方法分析7例妊娠晚期合并重症甲型流感患者的临床表现、胸部CT特点及治疗经过。结果经治疗后,7例患者均康复出院,出院后随访3个月未发现明显副反应及后遗症。结论晚期妊娠妇女感染甲型流感性肺炎后,使用奥司他韦抗病毒治疗及甲泼尼松龙治疗是安全有效的,对于危重症病例,早期终止妊娠并适时进行机械通气辅助呼吸治疗,以及早期行CRRT,可提高抢救成功率;氧合指数及肺部影像学表现可作为判断孕妇病情的重要参考指标。
Objective To investigate the clinical features and treatments for patients who suffered from severe new type influenza A（H1N1）（influenza A for short） in late pregnancy.Methods The clinical manifestation of 7 cases with severe influenza A during late pregnancy was analyzed along with the chest CT characteristics and therapy process.Results All patients,young women in late pregnancy,aged 21 to 32,without previous underlying diseases,presented symptoms of fever,coughing,and 3 of them complained of bloody sputum.Blood gas analysis showed hypoxemia to varying degrees.Imageological examination reported that all patients had multiple segmental pneumonia,which is mainly characterized by the diffuse distribution of ground-glass opacity and patchy shadow,particularly in the lower lobes of both lungs and pleura and that severe cases presented large area of consolidation with air bronchus.The imaging appearances of the patients who required the assisted breathing were consistent with the acute respiratory distress syndrome（ARDS）.A small amount of pleural effusion was found in 2 cases.The patients were all given oseltamivir and oethylprednisolone.Four cases underwent cesarean section,two of which presented acute respiratory distress syndrome（ARDS） and received endotracheal intubation,high PEEP mechanical ventilation and continuous renal replacement therapy（CRRT）.After treatment,all patients were discharged from hospital.Conclusion Late pregnancy women are a high-risk group of influenza A which may progress to severe pneumonia easily and quickly and even result in ARDS.The condition can be safely and effectively treated with antiviral oseltamirir and methylprednisolone.For severe cases,it is advisable to terminate the pregnancy early,to provide the mechanical ventilation properly and to apply CRRT timely.Oxygenation index and lung imaging appearances can serve as important reference parameters for judging the condition of the pregnant women.
出处
《福建医科大学学报》
2011年第1期61-64,共4页
Journal of Fujian Medical University
关键词
流感
人
妊娠并发症
感染性
肺炎
Influenza
Human
Pregnancy Complications
Infectious
Pregnancy
Pneumonia
