妊娠期白血病12例临床分析

发布时间：2018-04-22 04:20

本文选题：妊娠 + 白血病　；参考：《中国实用妇科与产科杂志》2017年03期

【摘要】：目的探讨妊娠期白血病的临床特征及诊疗经验。方法回顾性分析2002年1月至2014年12月中国医科大学附属盛京医院收治的妊娠期间首次发现或确诊复发的白血病患者12例的临床资料,除外孕前确诊且妊娠期间处于白血病完全缓解期者及产后发现白血病者。结果妊娠期首次发现白血病10例,复发2例。所有病例均行骨髓穿刺明确诊断,其中急性髓系白血病8例,慢性粒细胞白血病3例,慢性淋巴细胞白血病1例。确诊时处于早期妊娠3例,中期妊娠3例,晚期妊娠6例。7例产后行系统化疗,1例产后行骨髓移植,1例于妊娠状态下行化疗,1例放弃治疗,2例不详。随访11~124个月,死亡4例,失访3例,现处缓解期5例;分娩活婴共5例。结论妊娠的生理变化对白血病外周血的病理改变干扰不大,产检时对于疑似白血病病例应行骨髓穿刺确诊。妊娠期白血病的分娩期及产褥期常出现严重并发症,甚至危及生命,应引起足够重视。
[Abstract]:Objective to explore the clinical features and diagnosis and treatment experience of pregnancy leukemia. Methods from January 2002 to December 2014, the clinical data of 12 leukemia patients who were first found or diagnosed recurrent during pregnancy in Shengjing Hospital affiliated to China Medical University were analyzed retrospectively. Except those diagnosed before pregnancy and in complete remission of leukemia during pregnancy and those who found leukemia after delivery. Results Leukemia was found in 10 cases and recurrence in 2 cases for the first time in pregnancy. All cases were diagnosed by bone marrow puncture, including 8 cases of acute myeloid leukemia, 3 cases of chronic myeloid leukemia and 1 case of chronic lymphocytic leukemia. There were 3 cases of early pregnancy, 3 cases of second trimester pregnancy, 6 cases of late pregnancy, 7 cases of postpartum systemic chemotherapy and 1 case of postpartum bone marrow transplantation. Follow-up for 11 ~ 124 months, 4 cases died, 3 cases lost visit, 5 cases were in remission period, 5 cases were born live baby. Conclusion the physiological changes of pregnancy have little influence on the pathological changes of peripheral blood of leukemia. Serious complications, even life-threatening, often occur during delivery and puerperium of pregnancy leukemia, which should be paid more attention to.
【作者单位】：中国医科大学附属盛京医院妇产科;
【基金】：盛京自由研究者计划(201303)
【分类号】：R733.7;R714.2

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