国际妇产科学杂志

国际妇产科学杂志 ›› 2015, Vol. 42 ›› Issue (3): 348-351.

• 论著 • 上一篇    下一篇

妊娠合并肺炎23例临床分析

程帅，谢玉珍，何青，李映桃   

  1. 510150 广州医科大学附属第三医院产科，广州重症孕产妇救治中心，广东省产科重大疾病重点实验室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2015-06-15 发布日期:2015-06-15
  • 通讯作者: 李映桃

Clinical Analysis of 23 Cases with Pneumonia during Pregnancy

CHENG Shuai, XIE Yu-zhen, HE Qing, LI Ying-tao   

  1. Department of Obstetrics，The Third Affiliated Hospital of Guangzhou Medical University，Guangzhou Medical Centre for Critical Pregnant Women，Key Laboratory for Major Obstetric Disease of Guangdong Province，Guangzhou 510150，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2015-06-15 Online:2015-06-15
  • Contact: LI Ying-tao

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摘要： 目的：探讨妊娠合并肺炎的临床特征。方法：回顾性分析2005年1月1日—2013年12月30日我院收治的符合肺炎诊断标准，资料较完整的妊娠合并肺炎病例23例，按照孕周分为早期妊娠、中期妊娠、晚期妊娠3组，对各项临床特征进行统计学分析。结果：此期间妊娠合并呼吸系统疾病发生率3.652%（2 384/65 283），肺炎占妊娠合并呼吸系统疾病的0.965%（23/2 384），其中社区获得性肺炎占78.3%（18/23），医院获得性肺炎占21.7%（5/23）。23例患者中，早期妊娠合并肺炎2例（占8.7%），中期妊娠合并肺炎10例（占43.5%），晚期妊娠合并肺炎11例（47.8%），提示随着孕周的增加，罹患肺炎的人数增加。临床出现咳嗽82.6%（19/23），发热65.2%（15/23），呼吸急促60.9%（14/23），咳痰43.5%（10/23），气促在晚期妊娠合并肺炎患者中发生率较高，各组比较差异有统计学意义（P＜0.05）；咳嗽、咳痰、畏寒、发热等症状在不同妊娠期发生率差异无统计学意义（均P＞0.05）；不同孕周血常规、血生化指标差异无统计学意义（P＞0.05）。23例中合并贫血者占43.5%（10/23），说明贫血可能是孕妇罹患肺炎的高危因素之一。23例患者自然流产和早产的发生率均为8.7%（2/23），足月产82.6%（19/23），无新生儿死亡。结论：妊娠合并肺炎对母胎影响较大，伴发流产和早产发生率均较高。以社区获得性肺炎为主，妊娠晚期的肺炎病例数较妊娠早期、中期多，而临床表现与非妊娠妇女相似，但气促在妊娠晚期发生率较高。贫血是妊娠合并肺炎的高危因素之一。

关键词: 妊娠合并症, 肺炎, 危险因素

Abstract: Objective： To investigate the clinical characteristics of pregnancy with pneumonia. Methods：A retrospective review of all admissions from January 1，2005 to December 30，2013 included 23 women who had been hospitalized with pneumonia during pregnancy in our hospital. 23 cases were divided into three groups according the first trimester，the second trimester and the third trimester. Data of clinical manifestations，laboratory examinations，treatment and prognosis of these patients were obtained and studied. Results：The incidence of respiratory system disease during pregnancy was 3.652%，pneumonia accounted for 0.965%，the incidence of community-acquired pneumonia（CAP） was 78.3%（18/23），hospital-acquired pneumonia（HAP） was 21.7%（5/23）. 2 cases （8.7%） were in the first trimester，10 cases （43.5%） were in the second trimester，and 11 cases（47.8%） were in the third trimester. It suggested that the incidence of pregnancy with pneumonia accompanied with the trimester. The incidences of cough，fever，and shortness of breath and expectoration were 82.6% （19/23），65.2% （15/23），60.9%（14/23） and 43.5%（10/23），and shortness of breath is particularly evident in the third trimester，the difference was statistically significant（P＜0.05），but cough，expectoration，chills，fever and other symptoms has no significant differences in different trimesters （P＞0.05），the differences of blood count and biochemistry index were not statistically different in the different trimesters（P＞0.05）. On the other hand，cases with anemia was 43.5%（10/23），which was one of the risk factors of pregnant with pneumonia. The incidence of spontaneous abortion and premature delivery were 8.7%（2/23），and mature delivery were 82.6%（19/23），and no neonatal death. Conclusions：Pneumonia may be more severe in the pregnant woman，and carries significant risk to both mother and fetus. The incidence of CAP in the third trimester is higher than in the first and second trimester，and the clinical manifestations were similar with nonpregnant women，but has higher asthma incidence in the third trimester with pneumonia. Anemia is one of the risk factors of pregnancy complicated with pneumonia.

Key words: Pregnancy complications, Pneumonia, Risk factors