59例早、中期妊娠结核病患者的临床特征及预后

Clinical characteristics and prognosis of 59TB patients in early and mid-term pregnancy

目的对59例早、中期妊娠合并结核病患者治疗后临床效果进行回顾性分析,寻求妊娠合并结核病诊治经验。方法对我院收治的59例早、中期妊娠合并结核患者,从妊娠期间结核病的临床变化及妊娠期间与终止妊娠后治疗效果进行分析与总结,观察其相关性。结果妊娠合并单纯性结核性胸膜炎时,对胸膜炎病情影响不大,治疗效果良好,甚至不影响妊娠;而伴有空洞型肺结核、血行播散型肺结核的妊娠患者,妊娠阶段与结核病情变化及治疗效果有关,且胎盘部位结核DNA阳性率较高。结论妊娠早、中期就诊的单纯性结核性胸膜炎临床影响较小。合并空洞型肺结核及血行播散型肺结核时妊娠时期选择就诊后临床影响较大,早期妊娠确诊后及时给予规范抗结核治疗方案,效果优于妊娠中晚期。

Objective To retrospectively analyze the clinical effects on 59tuberculosis(TB)patients in early and mid-term pregnancy after the treatment,and to explore the experience of diagnosis and treatment of TB combined with pregnancy.Methods For 59TB patients in early and mid-term pregnancy,the clinical changes of TB during pregnancy,the effects of treatment in the pregnancy and after its termination were analyzed and summarized,and the correlation was observed.Results The pregnancy complicated with simple tuberculous pleurisy had little effect on pleurisy condition,which had good therapeutic effect without affecting the pregnancy.However,for pregnant patients with cavernous TB and hematogenous TB,there was a significant correlation among the pregnancy stage,the changes of TB condition and therapeutic effects,and the positive rate of DNA in placental TB was relatively high.Conclusion The clinical effect of treatment on simple TB pleurisy in early and mid-term pregnancy is relatively small,while that on cavernous TB and hematogenous TB in pregnancy was great.The standard anti-tuberculosis treatment plan should be timely given after the confirmed diagnosis in early pregnancy.And the therapeutic effect in early pregnancy is better than that in the middle or late pregnancy.