11例孕产妇甲型H1N1流感临床分析

Clinical anlaysis of 11 pregnant or postpartum women infected with influenza A(H1N1)

目的探讨孕产妇甲型H1N1流感临床特点。方法对我院收治的11例孕产妇甲型H1N1流感患者的临床资料进行回顾性分析。结果 11例患者中重症2例,危重症2例。11例均有咳嗽、咳痰,其中重症及危重症病例可伴有呼吸困难,危重症病例可出现咯血。轻症病例血常规、肝肾功能、心肌酶正常,重症及危重症可以出现白细胞下降或升高,肝肾功能和心肌损伤。重症病例发热时间及核酸转阴时间明显延长,2例重症病例早期应用奥司他韦,预后良好。2例危重症因延误治疗,病情迅速进展,预后不良。结论孕产妇甲型H1N1流感危重症比例及病死率较非孕人群明显增高,临床应早发现,早期给予奥司他韦治疗。

Objective To study the clinical features of pregnant or postpartum women infected with influenza A（H1N1）.Methods The clinical data of 11 pregnant or postpartum women infected with H1N1 treated in our hospital were retrospectively analyzed.Results There were two severe cases and two critically ill in these 11 patients.Symptoms of cough and expectoration were presented in all cases.And dyspnoea was associated in severe and critically ill cases.Hemoptysis was even found in critically ill cases.Laboratory indexes in blood and enzyme as well as liver and kidney function tests were mainly normal in mild cases,but a low or high white blood cell count and liver and kidney dysfunction were occured in severe and critically ill cases.Time of fever and nucleic acid clearance were obviously prolonged in severe cases.Two severe cases were treated with Oseltamivir early and the prognosis was good.While the other two critically ill cases were made rapidly progress in disease and had poor prognosis because of delays in treatment.Conclusions The proportion of critically ill patients and mortality of maternal cases with H1N1 were significantly higher than non-pregnant group.Early detection and clinical treatment with Oseltamivir should be adopted.