摘要
目的：探讨妊娠合并白血病患者的临床处理及妊娠结局。方法收集27例妊娠合并白血病患者的临床资料，回顾性分析其孕期特点、临床处理及妊娠结局进行分析。结果（1）孕期临床处理及妊娠结局：孕前诊断9例，8例均足月分娩，1例在孕早期流产后继续化疗。孕早期诊断3例：2例流产后化疗，1例足月分娩。孕中期诊断11例：6例足月分娩，1例死亡，4例行引产后化疗。孕晚期诊断的共4例，均足月分娩。（2）母婴随访情况：失访5例，其余随访时间6～144月，母亲12例存活，10例死亡；27例中有19例活产，分娩后胎儿Apgar评分均＞7分，随访至今仍健在，未发现胎儿畸形、发育不良、白血病等病史。结论白血病患者在病情缓解后慎重妊娠，可望得到较好的妊娠结局。白血病本身及治疗对于胎儿及孕妇存在一定风险，需要在有条件的综合性医院进行治疗及监管。
Abstract
Objective To discuss the treatment and prognosis of leukemia complicating pregnan‐cy . Methods The clinical data of 27 cases of leukemia complicating pregnancy were retrospectively ana‐lyzed . Data analyzed included pregnancy features ,clinical treatment ,and pregnancy outcomes . Results (1)The clinical treatment during pregnancy and pregnancy outcome:Of the nine cases diagnosed before pregnancy ,eight were delivered in full‐term and one continued chemotherapy after abortion in the early pregnancy term . Of the three cases diagnosed in the early pregnancy term ,two received chemotherapy after abortion and one was delivered in full‐term . Of the eleven cases diagnosed in the mid term ,six were delivered in full‐term ,four received chemotherapy after induction of labor and one died . Four cases were diagnosed in the late pregnancy term ,all of whom were delivered in full‐term . (2) maternal and infant follow‐up:five cases were lost to follow‐up ,the rest were followed up for 6~144 months ,twelve cases were alive and ten cases were dead . There were nineteen live births in twenty seven cases . The Apgar scores for the 19 cases were greater than seven points after delivery ,they are all still alive . Among them we did not find any history of fetal malformation ,dysphasia ,leukemia . Conclusion Should leukemia pa‐tients in remission be careful about pregnancy ,there may be a good pregnancy outcome . There is risk as result of leukemia and the treatment for the leukemia to the fetus and pregnant women ,needing to be in a general hospital capable of the comprehensive treatment and supervision .
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NSTL
维普
万方数据