子痫伴发脑型疟疾24例临床分析

Clinical Study on 24 Cases of Eclampsia with Cerebral Malaria

目的探讨子痫伴发脑型疟疾的临床特点。方法对１９９５年７月至１９９８年１０月间，坦桑尼亚桑给巴尔列宁医院收治的２４例子痫伴发脑型疟疾患者的临床资料进行回顾性分析。结果全组患者均有不同程度的昏迷、高热和抽搐，所有患者血涂片查疟原虫均为阳性。并接受了抗疟疾、抗子痫的综合治疗。２４例中１７例子痫患者经积极的综合治疗，２～３天内清醒，生命体征逐渐平稳，并顺利终止妊娠。７例死亡，其中昏迷伴黑尿热、肾功能衰竭４例，心肺功能衰竭、产后大出血及产褥感染各１例。死胎８例，死产７例，活产９例。结论子痫伴脑型疟疾是凶险的产科急症，应以综合治疗为主，迅速终止妊娠是治愈本病的关键。

Objective To explorethe clinical characteristics of eclampsia with cerebral malaria. Methods A retrospective analysis was done in 24 inpatient cases of eclampsia with cerebral malaria in Mnazimmoja Hospital of Zanzibar from Jul. 1995 Oct. 1998. All had varying degrees of coma, high fever and convulsion with anemia and splenomeguly. In all cases, malarial parasitein in blood smear was positive and underwent antimalaria treatment, antieclamptic convulsion treatment and complex treatment for the prevention of complications, so that 20 of them could terminate pregnancy rapidly. Results 17 patients were conscious 23 days after complex treatment. Their vital signs were gradually stable and pregnancy termination was smooth. 7 patients died, 4 of them due to complicated with blackwater fever and renal failure, one with cardiopneumatic failure, postpartum hemorrhage and puerperal infection respectively. The number of fetal deaths, stillbirths and live births was 8, 7 and 9 respectively. Conclusion Eclampsia with cerebral malaria is an acute and dangerous obstetrical disease. Complex therapy, we think, should be given mainly to the patients. Termination of pregnancy is the key to effective cure of the disease.