高危妊娠合并系统性红斑狼疮患者的护理

Nursing Care of Patients with High Risk Pregnancy Complicated with Systemic Lupus Erythematosus

目的观察在高危妊娠合并系统性红斑狼疮患者的护理干预方法分析。方法方便选取2016年1月-2018年1月时期该院收治以高危妊娠合并系统性红斑狼疮为诊断的患者32例,在妊娠期完善健康知识宣教及随访,提高服药、治疗的依从性,在妊娠期及围产期间重视胎儿监护,完善妊娠期、产时护理及产后并发症观察与护理。并对患者进行1年的随访。结果妊娠结局:1例药物流产,9例自然分娩,22例剖宫产。患者结局:30例病情控制相对稳定,于产后4~7 d出院,在风湿免疫科科随诊;2例病情危重多脏器受累,产后1~5 d转ICU进一步治疗。新生儿结局:1例因SLE病情重度活动行药物引产,1例分娩后死胎,2例早产中1例为极低体重儿,经抢救存活,30例新生儿存活。所有患者均无SLE发展及进行性加重。结论在高危妊娠合并系统性红斑狼疮患者中,在妊娠期与围产期采取针对性的护理干预措施,可明显提高患者系统性红斑狼疮的治疗效果,更减少了患者并发症的发生,提高围生儿存活率,保证了母婴安全。

Objective To observe the nursing intervention of patients with high-risk pregnancy complicated with systemic lupus erythematosus.Methods Convenient select a total of 32 patients with high-risk pregnancy complicated with systemic lupus erythematosus were enrolled in our department from January 2016 to January 2018.In the pregnancy,we improved health education and follow-up during pregnancy to improve medication and treatment compliance,paid attention to fetal monitoring during pregnancy and perinatal period,improved the observation and care of pregnancy,postpartum care and postpartum complications.The patient was followed for 1 year.Results Pregnancy outcomes: 1 case of medical abortion,9 cases of natural delivery,and 22 cases of cesarean section.Patient outcome: 30 cases were relatively stable in disease control,discharged 4-7 days after delivery,followed up in rheumatology and immunology department;2 cases were involved in critically ill multiple organs,and were further treated by ICU after 1-5 days postpartum.Neonatal outcomes: 1 case of SLE caused by severe activity,1 case of stillbirth after childbirth,2 cases of premature delivery,1 case of very low birth weight,survived by rescue,30 newborns survived.All patients had no SLE development and progressive exacerbations.Conclusion In high-risk pregnancy patients with systemic lupus erythematosus,targeted nursing interventions during pregnancy and perinatal period can significantly improve the treatment of systemic lupus erythematosus,reduce the incidence of complications,and improve the circumference.The survival rate of the children ensures the safety of the mother and the baby.