妊娠并发脑血管病临床研究

Clinical Study of Pregnancy and Cerebrovascular Disease Complication

目的 探讨妊娠合并脑血管病的发病时间、病因、危险因素与临床表现,早期诊断,改善母儿预后.方法 对1998年1月～2005年12月我院收治的妊娠合并脑血管病的10例临床病例资料进行回顾性分析.结果 10例妊娠合并脑血管病的病例,确诊脑出血5例,上矢状窦血栓3例,腔隙性脑梗死1例,羊水栓塞致脑栓塞1例.脑出血患者中重度子痫前期(子痫)3例,脑血管畸形1例,血小板减少性紫癜1例.孕妇死亡2例,其余保守治疗好转出院.8例围生儿全部存活.结论 妊娠合并脑血管病好发于重度子痫前期(子痫)、脑血管畸形,血液高凝状态与上矢状窦血栓有关.当出现神经症状及体征时,临床医生应考虑到脑血管病的可能,及时诊治,多数孕产妇可取得较好结局.

Objective To investigate the timing,etiology,risk factors and clinical manifestations of pregnancy and cerebrovascular disease complication.We should diagnose early to improve the matemal and the fetal outcomes.Methods Retrospectively analysis the clinical data of 10 pregnant womem with cerebrovascular disease complication in our hospital from January 1998 to December 2005.Results 10 patients with cerebrovascular disease complication were identified,including 5 with intracerebral hemorrhage,3 with superior sagital sinus thrombus,1 with lacunar infarction and 1 with cerbral embolism induced by amniotic embolism.Among intracerebral hemorrhage cases,3 were diagnosed with preeclampsia(eclampsia),1 with cerebral vessel malformation,1 with thrombocytopenic purpure.2 mothers died,the other discharged with the conservative treatment.8 fetus servived.Conclusions Associated risk factors of cerebrovascular disease related to pregnancy were preeclampsia/eclampsia,cerebral vessel malformation,hypercoagulability states were related to superior sagital sinus thrombus.Whenever the neurological symptoms and signs presented,the clinicians should think of the cerebrovascular disease.Proper management in time will achieve the better outcome for the mother and fetus.