妊娠合并支气管哮喘急性发作的发病特点及治疗原则

摘要

目的 探讨妊娠合并支气管哮喘急性发作的发病特点及治疗原则.方法 对30例妊娠合并支气管哮喘急性发作患者的临床资料进行回顾性分析.结果 25例妊娠合并支气管轻、中度哮喘急性发作患者经吸氧、应用β受体激动剂和糖皮质激素、补液、纠正水电解质平衡等治疗后,母婴预后良好,无一例出现严重并发症;5例重度及危重哮喘急性发作患者,经半卧位、吸氧、补液、纠正酸碱电解质平衡、应用β受体激动剂和糖皮质激素、广谱抗生素、氨茶碱等药物综合治疗后,仍有4例合并肺部感染,1例发生呼吸性酸中毒,1例发生呼吸性酸中毒并代谢性碱中毒,4例发生胎儿生长受限.结论 妊娠可使部分哮喘患者出现急性发作并加重,对重度及危重哮喘急性发作患者,以半卧位、吸氧、补液、纠正酸碱电解质平衡、应用β受体激动剂和糖皮质激素、广谱抗生素、氨茶碱等综合治疗是主要处理原则.%Objective To study the clinical characteristics of acute asthma during pregnancy,focusing on management of pregnant women presenting with an acute exacerbation.Methods A prospective observational study was conducted in 30 cases of acute exacerbations during pregnancy.Results The prognosis of 25 patients with mild or moderate asthma was good for both mother and fetus;none had severe complications.Among 5 women who had severe exacerbations,there were 4 pulmonary co-infections,1 with respiratory acidosis,1 with respiratory acidosis plus metabolic allkalosis,and 4 with fetal growth-restriction.Conclusions,This study highlights that pregnancy can worsen asthma control in some women.Effective management and prevention of asthma exacerbations during pregnancy is key to ensuring the safety of the mother and the fetus.