国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (2): 95-97.

• 论著 • 上一篇    下一篇

34例系统性红斑狼疮患者行中期引产术临床分析

陈蔚琳, 金 力,刘欣燕, 彭 萍   

  1. 100730 北京，中国医学科学院 北京协和医学院 北京协和医院妇产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-03-15 发布日期:2013-03-15
  • 通讯作者: 金 力

Analysis of Mid-trimester Termination of Pregnancy in 34 Women with Systemic Lupus Erythematosus

CHEN Wei-lin，JIN Li，LIU Xin-yan，PENG Ping   

  1. Department of Obstetrics and Gyneocology，Peking Union Medical College Hospital，Chinese Academy of Medical Science & Peking Union Medical College，Beijing 100730，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-03-15 Online:2013-03-15
  • Contact: JIN Li

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摘要： 目的：分析系统性红斑狼疮（SLE）患者于妊娠中期终止妊娠的原因及引产方式的选择，探讨SLE患者的生育管理和中期引产相关问题。方法：回顾性分析1994年1月—2012年4月收治的34例SLE患者于妊娠中期行中期引产的相关数据。引产原因分为可避免和不可避免2类，可避免中期引产指社会因素和SLE治疗中意外妊娠；不可避免中期引产包括胎儿因素、妊娠期SLE初发和疾病稳定期计划内妊娠后妊娠期SLE复发。结果：可避免中期引产者共15例（占44.1%），不可避免中期引产者共19例（占55.9%）。引产方式中：12～16周行大钳刮术者3例，行米非司酮加米索前列醇药物引产者2例，17～28周行依沙吖啶羊膜腔内引产者25例，行剖宫取胎术者4例。除1 例钳刮时大出血外，无手术并发症。2组相比妊娠周及引产方式差异无统计学意义，但妊娠期疾病活动者在不可避免组（16/19）显著高于可避免组（6/15），差异有统计学意义（P＜0.05）。结论：SLE妇女缺乏生育管理，应加强该人群的妊娠前和避孕咨询，以减少可避免的引产手术。此类患者的中期引产系高危手术，术前应全面评估，选择适合的手术方法以确保母亲的安全。

关键词: 红斑狼疮, 系统性, 妊娠中期, 引产, 避孕, 计划生育服务

Abstract: Objective： To evaluate the optimal operation method for the midtrimester termination of pregnancy in those women with systemic lupus erythematosus（SLE），and to investigate the family planning and midtrimester termination methods in those SLE women. Methods：A retrospective study was carried out on 34 cases with SLE who accepted mid-trimester induced abortion in Peking Union Medical College Hospital from Jan. 1994 to Apr. 2012. Results：There were 15（４４．１％） avoidable abortion cases with the reasons of social factors or unintended pregnancy during SLE treatment. There were 19（５５．９％) inevitable abortion cases. Main reasons included fetus factors，the first attack of SLE during pregnancy，SLE flare with planning pregnancy during the SLE stable period. The abortion methods included：3 cases with dilatation and evacuation in 12-16 weeks of pregnancy；Two cases with medical procedures with mifepristone plus misoprostol；■ cases with amniocentesis after injection of ethacridine into amniotic sac in 17-28 weeks of pregnancy；Four cases with cesarean section. There are no difference between two groups in pregnant week and method of abortion. Lupus flares during pregnancy of the inevitable group （16/19） was more than that of the evitable group（6/15，P＜0.05）. One massive hemorrhage happened in the dilatation and evacuation. There were no more complications. Conclusions：The midtrimester induced abortion was safe for SLE women under SLE well-controlled，but the operation should be valued as high risk. Those SLE patients should be given timely and accurate family planning guidance in case of those concomitant risks during unintended pregnancy.

Key words: Lupus erythematosus, systemic, Pregnancy trimester, second, Labor, induced, Contraception, Family planning services