妊娠合并甲型H1N1流感危重症患者的临床特点及随访研究

发布时间：2019-03-02 10:57

【摘要】：目的了解妊娠合并甲型H1N1流感(甲流)危重症患者的临床特点,探讨甲流对患者的长期影响。方法选取2009年11月—2010年2月中国医科大学附属盛京医院收治的妊娠合并甲流危重症患者7例,收集其临床资料,分析住院期间疾病严重程度及肺部影像特点,并在出院后1、5年进行门诊随访,观察临床症状、胸部CT表现及肺功能指标变化情况。另外对存活新生儿进行临床症状及生长发育测评随访。结果 7例危重症患者年龄为22~39岁,平均为27.3岁;孕周为22~38+6周,平均为32周;均选择了剖宫产终止妊娠,其中死亡2例,存活5例。5例存活患者气管插管时间为5~21 d,平均为13.6 d;住院时间为4~35 d,平均为19.4 d。5例存活患者随访1年后,有2例存在临床慢性呼吸道症状,胸部CT异常3例,肺弥散功能异常5例,合并小气道功能异常3例;随访5年后,仍有2例存在临床慢性呼吸道症状,胸部CT异常3例,肺弥散功能异常5例,合并小气道功能异常1例。3例存活新生儿孕周为34+2~35+1周,平均为34.5周;体质量为1 380~2 120 g,平均为1 881 g;未发现H1N1流感病毒感染;在随访1、5年中,生长发育与其他婴幼儿无异。结论妊娠合并甲流危重症患者出院1、5年后,胸部CT异常和肺功能障碍仍较为常见,应重视对此类患者的实验室检查以及长期随访。
[Abstract]:Objective to investigate the clinical characteristics and long-term effects of influenza A (A) flu on pregnancy patients with H1N1 influenza A (influenza A). Methods from Nov. 2009 to Feb, 2010, 7 cases of pregnancy complicated with A-stream critical illness were selected from Shengjing Hospital, affiliated to China Medical University. The clinical data were collected and the severity of the disease and the characteristics of lung imaging during hospitalization were analyzed. The clinical symptoms, chest CT findings and pulmonary function indexes were observed 1 and 5 years after discharge. In addition, the clinical symptoms and growth and development of the surviving newborns were evaluated and followed up. Results the age of 7 critically ill patients was 22 / 39 years old (mean 27.3 years), the gestational week was 22 / 38.6 weeks (mean 32 weeks), and the mean age of the patients was 27.3 years old. Cesarean section was used to terminate pregnancy, of which 2 died and 5 survived. The tracheal intubation time of 5 surviving patients was 5 days (mean 13.6 days). After 1 year follow-up of 19.4 d.5 surviving patients, there were 2 cases with clinical chronic respiratory symptoms, 3 cases with abnormal chest CT, 5 cases with abnormal pulmonary diffusion function and 3 cases with abnormal small airway function. After 5 years of follow-up, there were 2 cases with clinical chronic respiratory symptoms, 3 cases with abnormal chest CT, 5 cases with abnormal pulmonary diffusion function and 1 case with abnormal small airway function. The gestational weeks of 3 surviving newborns were 34.2 to 35.1 weeks (mean 34.5 weeks). The body mass was 1 380 g / 2 120 g, with an average of 1 881 g, no infection of H1N1 influenza virus was found, and the growth and development were the same as those of other infants during the follow-up period of 1 year. Conclusion the abnormality of chest CT and pulmonary dysfunction are still common 5 years after discharge of critically ill patients with influenza A in pregnancy. We should pay more attention to laboratory examination and long-term follow-up of these patients.
【作者单位】：中国医科大学附属盛京医院妇产科;
【基金】：辽宁省医学高峰工程建设项目——妊娠期甲型H1N1流感病毒感染危重症救治临床与基础研究
【分类号】：R714.251

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