围生期重症肺炎6例临床分析

Clinical Analysis of 6 Pregnant Women with Severe Pneumonia

目的:探讨围生期重症肺炎的临床特点和处理方法,为孕产妇重症肺炎早期诊断提供临床经验。方法:对2009年11～12月收治的6例围生期重症肺炎病例进行回顾性分析,3例确诊甲型H1N1流感,3例病原体不明。结果:6例重症肺炎均行抗生素防止继发感染治疗,气管插管,呼吸机辅助通气,3例确诊甲型H1N1流感病例给予磷酸奥司他韦胶囊抗病毒治疗并适时终止妊娠,经积极抢救无效死亡,新生儿存活1例;3例病原体不明,其中1例死亡,2例出院时呼吸困难,新生儿存活1例。结论:孕产妇感染流感可以发展为重症肺炎,特别是甲型H1N1流感高发期。围生期如出现流感样症状应及时治疗,避免发展为重症肺炎,同时产科处理强调个体化原则。

Objective：To investigate the clinical characteristics and treatment of pregnant patients with severe pneumonia and provide clinical experience of early diagnosis of severe pneumonia.Methods：Six cases of pregnant patients complicates with severe pneumonia from November 2009 to December 2009 in The Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed.Three pregnant patients were infected with severe H1N1 influenza,the other 3 cases had indefinite pathogen.Results：The antibiotic therapy was used in six pregnant patients complicated with severe pneumonia to prevent secondary infection.Tracheal cannula and assisted ventilation were used in all of the patients.3 cases infected with H1N1 virus were given oseltamivir phosphate capsules and terminated pregnancy in time,but all of them were died and only one neonate was alive.Among the other 3 cases with indefinite pathogen,one was died and 2 cases were with dyspnea when discharge from hospital.There was only one neonate was alive.Conclusions：Pregnant women are easy to progress to severe pneumonia when infected with influenza,especially during high-incidence season of severe H1N1 virus influenza.If having symptom of influenza they should go to hospital in time.The shorter of the course of the disease,the better of the patient recovery and the higher survival rate of neonate.Pregnancy patients with severe pneumonia need individualized therapy.