孕产妇甲型H1N1流感12例临床观察

Clinical investigation on 12 cases of new influenza A(H1N1)in pregnant and postpartum women

目的探讨孕产妇甲型H1N1流感病例的临床特点。方法收集我院收治的12例孕产妇甲型H1N1流感确诊病例,常规检测血常规、血气分析、肝肾功能及心肌酶学、淋巴细胞亚群、胸片及胸部CT。采用奥司他韦、氧疗及呼吸支持、抗感染、对症支持等综合治疗。结果患者以发热、咳嗽、咳痰、流涕、咽痛为主要症状,重症可出现胸憋气紧;91.7%的患者白细胞正常或增高,9例患者肺部病灶表现多样,进展快,2例发展为急性呼吸窘迫综合征(ARDS);部分病例出现多脏器损害表现;奥司他韦、有效氧疗及机械通气、抗感染及支持治疗有效。结论孕产妇甲型H1N1流感患者白细胞正常或增高;以肺部病变为主,伴有多脏器功能异常表现;中晚期孕妇及产妇甲型H1N1流感易发展为重症;孕产妇甲型H1N1流感易合并细菌感染,建议早期应用抗生素治疗。

Objective To study the clinical features of cases of new influenza A (H1N1) in pregnant and postpartum women. Methods We collected 12 confirmed cases of new influenza A (H1N1) in pregnant and postpartum women hospitalized at The Forth People's Hospital of Taiyuan .The lab tests, including blood routine, blood gas analysis, liver and renal function tests, myocardium enzymology , lymphocyte subpopulations, chest radiograph and computed tomogram were analyzed. The cases were cured with combined therapy :oseltamivir, oxygen therapy, anti-infection or symptomatic treatment. Results Fever , cough , expectoration , nasal discharge and sore throat were the principal symptoms , severe patients show oppression in thest and breath shortness. The ratios of normal and increased WBC were 91.7%.9 cases' chest radiograph or computed tomogram were diverse and the disease developed quickly, two patients grew ARDS. Some cases showed the impairment of multiple organs.Oseltamivir, oxygen therapy , mechanical ventilation , anti-infection and supporting therapy were effective for improvement of this patient. Conclusion The WBC of cases of new influenza A (H1N1) in pregnant and postpartum women was normal or increased. The cases show mainly pulmonary lesion with multi-organ dysfunction.The women in the Second and Third Trimester and the postpartum women suffer more likely develop severe cases .The cases of new influenza A (H1N1) in pregnant and postpartum women combined more likely with bacterial infection and were suggested to treat with antibiotics in early stage.