摘要
目的 提高妊娠伴发霍乱的治疗水平。方法 报告了1997年11月～1998年1月桑给巴尔暴发的一次霍乱大流行,其中36例妊娠妇女伴发霍乱者被收住院治疗。轻型14例,重型22例。所有病例粪便常规检查霍乱弧菌均阳性。在补液、补充电解质,调节酸碱干衡紊乱的同时,积极处理死胎及流产病例。对孕周>35周者,当孕妇腹泻减轻、休克纠正、病情好转后,不论胎儿是否存活,均应迅速终止妊娠。结果 14例轻型霍乱的孕妇痊愈出院,22例重型霍乱的孕妇中痊愈出院11例,死亡11例,其中4例死于肾功能衰竭,4例死于胎盘滞留、胎盘残留所致的产后大出血,3例死于心肺功能衰竭。36例胎儿中,死胎伴流产22例,死产3例,活产6例,5例维持正常妊娠,随母亲出院。结论 妊娠伴发霍乱是一种起病急、病情变化快、严重威胁母儿生命的烈性传染病,治疗上除快速大量补液外,迅速安全地终止妊娠也是治疗的关键。
[Abstract] Objective To improve the treatment for gestation with cholera.Methods A big break-out of pandemic cholera in Zanzibar from Nov . 1997 to Jan. 1998 was reported, in which 36 pregnant patients with cholera was admitted. Light one 14 cases, heavy one 22 cases. All patients' vibrio cholera was positive in examination of stool. At the same time of fluid infusion, electrolyte replacement and acid-base imbalance regulation, vigorous action to treat stillbirth and abortion was taken. To those whose pregnant weeks were > 35, after the diarrhea stopped, shock corrected and the condition stabilized, whether the fetus was alive or not, prompt stop of pregnancy should be done. Results 14 pregnant patients of light cholera were all recovered and discharged. For 22 heavy ones, recovered and discharged 11, dead 11, and 4 of them died of renal failure, 4 of retained placenta and residual placenta induced postpartum hemorrhage,3 of cardiopneumatic failure. In 36 fetuses, stillbirth with abortion 22, dead birth 3, live birth 6, normal pregnancy and discharged with the mother 5. Conclusion Gestation with cholera is a critical infectious disease when coming on and quick to change worse, seriously imperilling the life of the mother and baby .In treating this disease, besides quick and large quantities of fluid infusion and electrolyte replacement, to stop pregnancy quickly and safely is also of critical importance.
