38例妊娠并发肺结核患者个体化护理干预下的临床疗效分析

The clinical efficacy analysis of 38 pregnant women suffering from tuberculosis with individualized nursing intervention

目的 分析并总结妊娠并发肺结核患者的临床特征及护理经验.方法 2013年1月至2015年12月兰州市肺科医院收治的妊娠并发肺结核患者共38例,对患者的抗结核治疗方案（包括妊娠患者的治疗、新生儿的预防和治疗）和护理措施（包括心理护理、用药护理、结核专科护理、产科专科护理和饮食护理）进行回顾性分析.结果 38例患者均在个体化的护理措施下进行抗结核药物治疗,31例患者肺结核治愈,5例完成疗程,2例因结核病病情危重,人院时出现呼吸衰竭,治疗无效死亡.其中28例患者终止妊娠;其余8例患者在抗结核药物治疗的同时继续妊娠,1例足月自然分娩,3例足月行剖宫产术,4例早产,未发现宫内感染结核病的患儿.新生儿中5例为低体质量儿;3例活动性肺结核患者娩出的婴儿,在出生后立即行结核菌素皮肤试验,并给予异烟肼预防性治疗3个月,未出现结核中毒症状.结论 妊娠并发肺结核的患者在抗结核药物治疗和个体化护理的措施下,大部分患者能够获得临床治愈,胎儿宫内感染结核病的风险较低.

Objective To analyze and summarize the clinical characteristics and nursing experience of preg- nant women suffering from tuberculosis （TB）. Methods The related data of 38 pregnant women suffering from TB who were treated in Lanzhou Puhnonary Hospital between January 2013 to December 2015 were retrospectively analyzed, which including anti-TB treatment regimen （including the treatment of patients with pregnancy, and the prevention and treatment of the newborn）, nursing measures （including psychological nursing, medicine nursing, TB specific nursing, obstetrical nursing and diet nursing）. Results Thirty eight patients received anti TB drug treatment with individualized nursing measures. Thirty-one patients were cured, 5 patients completed treatment and 2 patients died because of critical condition. There were 28 patients terminated pregnancy, 8 patients continued pregnancy while received anti-TB treatment, 1 patient had natural delivery at full term, g patiems underwent cesarean section at full term, and 4 patients had premature delivery, there were no newborn of intrauterine infection. Five newborns were low birth weight, 3 newborns whose mothers were active TB patients had taken tuberculin skin test immediately, and given isoniazid prophylactic treatment for 3 months, and there were no tuberculosis toxic symp- toms appeared. Conclusion Most of the pregnant patients complicated with TB can get clinical cure with individua- lized nursing intervention, and the risk of fetal intrauterine infection of TB is low.