妊娠晚期合并甲型H1N1流感8例临床分析

CLINICAL ANALYSIS OF INFLUENZA A VIRUS INFECTION IN LATE TRIMESTER PREGNANT WOMEN;A REPORT OF 8 CASES

目的探讨妊娠晚期合并甲型H1N1流感的临床特征和治疗方法,为该病的诊断和处理提供依据。方法对本院收治的8例妊娠合并甲型H1 N1流感病例的相关资料进行回顾性分析。结果 8例患者入院即协同重症监护病房(intensive care unit,ICU)、呼吸内科、麻醉科会诊。综合考虑孕妇状态选择麻醉方式,行急诊剖宫产术,其中全身麻醉6例、硬膜外麻醉1例、腰麻-硬腹外联合麻醉1例,术后给予呼吸支持、抗病毒、预防肺部感染及营养支持等综合治疗,临床症状明显改善,痊愈出院7例,死亡1例,新生儿全部存活。结论妊娠晚期合并甲型H1N1流感患者及时以剖宫产终止妊娠是改善母儿预后的关键措施。此外,多学科协作治疗是提高抢救成功率的根本。

Objective To investigate the clinical characteristics and treatments of H1N1 influenza during the late trimester of pregnancy and provide evidences for its diagnosis and managements. Methods The data of 8 gravidas with H1 N1 influenza were analyzed retrospectively. Results All the 8 cases were given consultation of ICU, respiration and anesthesiology department at the moment of admitted. The mode of anesthesia was chosen considering the state of the gravidas, which included general anesthesia 6 cases,epidural anesthesia 1 case and combined spinal and epidural anesthesia 1 case. All the patients received the emergency cesarean section. After operation, all the cases were given comprehensive management, such as respiration maintenance, anti - virus, prevention of lung infection and nutrition maintenance and so on ,clinical symptoms were obviously improved ,Tcases cured, l case died ,the neonatuses all survived. Conclusion Immediately cesarean section to terminate pregnancy is a critical measurement to improve the prognosis for late trimester pregnant women combined with H1 N1 influenza. Moreover,the management of multi - disciplinary cooperation is the fundament of rescue achievement ratio.