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目的探讨妊娠合并重症新型甲型H1N1流感的临床及治疗特点。方法对2009年11月7日至12月18日中国医科大学附属盛京医院收治的妊娠合并重症新型甲型H1N1流感住院的13例患者临床资料进行回顾性分析。结果13例患者均为妊娠中晚期,均伴有发热、气短症状。11例有低蛋白血症,6例脑钠肽增高,7例D-二聚体增高,10例氧合指数小于300。7例入住重症监护病房(ICU),2例死亡。8例行紧急剖宫产手术,其中4例新生儿存活,3例胎死宫内,1例新生儿死亡。入住ICU的患者平均孕龄为31.7周,而非入住ICU的患者平均孕龄为21.7周,两组差异有统计学意义(P<0.01)。结论妊娠妇女是重症新型甲型H1N1流感的高危人群;孕龄与病情严重程度相关;适时中止妊娠、抗凝及负液平衡治疗对预后至关重要。
Objective To investigate the clinical and therapeutic characteristics of severe new-type influenza A (H1N1) in pregnancy. Methods The clinical data of 13 patients admitted to Shengjing Hospital Affiliated to China Medical University between November 7, 2009 and December 18, 2009 were retrospectively analyzed. Results All the 13 patients were in the second trimester of pregnancy with fever and shortness of breath. 11 cases had hypoproteinemia, 6 cases of brain natriuretic peptide increased, 7 cases of D-dimer increased, 10 cases of oxygenation index less than 300.7 admitted to intensive care unit (ICU), 2 died. 8 cases of emergency cesarean section surgery, of which 4 cases of neonatal survival, 3 cases of fetal death, 1 case of neonatal death. The average gestational age of patients admitted to the ICU was 31.7 weeks, while the average gestational age of non-ICU patients was 21.7 weeks. There was significant difference between the two groups (P <0.01). Conclusions Pregnant women are at high risk of severe new type A (H1N1) infection. Gestational age is related to the severity of the illness. Timely termination of pregnancy and anticoagulation and negative fluid balance therapy are of critical importance to prognosis.