妊娠合并中枢神经系统感染10例临床分析

Clinical analysis of pregnancy complicated with central nervous system infection in ten cases

目的总结妊娠合并中枢神经系统（CNS）感染患者的临床特征、影像学改变和脑脊液特点,探讨妊娠合并CNS感染的孕期诊断及治疗方法。方法回顾性分析2010年1月至2015年1月在首都医科大学附属宣武医院检查并治疗的10例妊娠合并CNS感染患者的临床资料,分析其孕期诊断、治疗、分娩及产后管理。结果 10例妊娠合并CNS感染患者,初产妇9例,经产妇1例;年龄21～33岁,发病孕周为8＋～34周,妊娠期间死亡1例,合并妊娠期糖尿病1例,胎膜早破1例,早产1例。全身麻醉下行子宫下段剖宫产术4例,自然分娩1例,人工流产2例,中期引产2例。5例新生儿存活。结论妊娠合并CNS感染一旦发生,会危及生命中枢,病死率及致残率很高,严重威胁母婴生命安全;但在产科医生、神经外科、神经内科、儿科及麻醉科医师的密切协作下,能最大限度地争取良好的妊娠结局。

Objective To summarize the clinical features,imaging and cerebrospinal fluid characteristics of several ca- ses of pregnancy complicated with central nervous system infection, and to discussion the diagnosis and treatment of pregnancy complicated with central nervous system infection during pregnancy. Methods The clinical data of ten cases of pregnancy complicated with central nervous system infection in Xuanwu Hospital, Capital Medical University from Janurary 2010 to Janu- rary 2015 were analyzed retrospectively. The diagnosis and treatment during pregnancy, childbirth and postnatal management were disscussed. Results There were 9 cases of primipara and 1 case of maternal in the 10 cases of pregnancy complicated with central nervous system infection. The age of them was 21 - 33 years old. Incidence of gestational week was 8 ＋ - 34 weeks. One case died during pregnancy, one patient combined with gestational diabetes mellitns, one case was premature rupture of membra, one case was induction of labour in second trimester. Five cases of neonatus survived. Conclusions Once pregnancy complicated with central nervous system infection occured, its clinical manifestations is critically, the rate of mortality and disa- bility is high,it has serious threat to maternal and child safety. But under the effort of the obstetricians, neurosurgery, neurolo- gy, pediatric anesthesiologists, good pregnancy outcomes will be had.