妊娠合并感染性心内膜炎是导致孕产妇死亡的非产科因素的主要病因之一。该疾病早期临床表现多为发热、伴或不伴心脏杂音等非特异性症状为主,这也是不易早期诊断的原因之一。由于妊娠期女性血流动力学改变及免疫抑制状态,该疾病往往进展迅速,短时间出现急性心力衰竭、心源性休克、脓毒血症甚至呼吸心跳骤停等危及母胎生命的严重并发症。本文报道了1例妊娠中期合并感染性心内膜炎的患者,对其早期诊断及治疗方式进行讨论,旨在为临床治疗提供参考。Pregnancy with infective endocarditis is one of the main causes of non-obstetric factors leading to maternal mortality. The early clinical manifestations of this disease are unspecific symptoms such as fever with or without cardiac murmur, which is also one of the reasons for the difficulty of early diagnosis. Due to the hemodynamic changes and immunosuppression of women during pregnancy, the disease often progresses rapidly, and leads to serious complications such as acute heart failure, cardiogenic shock, sepsis and even respiratory and cardiac arrest occur in a short time. This paper reports a case of pregnancy woman with infective endocarditis, discussing its early diagnosis and treatment modalities, aiming to provide a reference for clinical treatment.
妊娠合并急性胰腺炎是一种少见但潜在严重的疾病,甚至可能危及母婴生命。因此及时诊断和有效治疗对改善母婴预后十分重要。胆结石疾病与高甘油三酯血症是妊娠合并急性胰腺炎的常见病因。其中并发症风险最大的是由高甘油三酯血症引起的急性胰腺炎。此种类型胰腺炎的治疗重难点在妊娠期高脂血症的管理。目前国内外尚无指南。本文报道了一例妊娠合并急性胰腺炎的患者,并探讨了其诊断和治疗策略。本案例患者在使用双重血浆置换、非诺贝特、omega-3脂肪酸等降脂药物及其他治疗后病情得到显著改善,顺利分娩一活婴,为该疾病的诊治和妊娠期高脂血症的管理提供了很好的参考意义。Acute pancreatitis during pregnancy is a rare but potentially serious disease that may even endanger the life of the mother and child. Therefore, timely diagnosis and effective treatment are very important to improve maternal and infant prognosis. Gallstone disease and hypertriglyceridemia are common causes of acute pancreatitis during pregnancy. The highest risk of complications is acute pancreatitis caused by hypertriglyceridemia. The treatment of this type of pancreatitis is difficult in the management of hyperlipidemia during pregnancy. At present, there are no guidelines at home or abroad. This article reports a case of pregnancy complicated with acute pancreatitis, and discusses its diagnosis and treatment strategy. In this case, the patient’s condition was significantly improved after the use of lipid-lowering drugs such as double plasma exchange, fenofibrate, omega-3 fatty acids and other treatments, and a live baby was delivered successfully, which provided a good reference for the diagnosis and treatment of this disease and the management of hyperlipidemia during pregnancy.
暂无评论