妊娠合并肺炎25例临床护理分析

摘要

Objective To investigate clinical and nursing features of pneumonia complicating pregnancy and to provide proposal on standard nursing,treatment and prevention.Method Retrospectively analyzed clinical and nursing features of 25 cases of pneumonia complicating pregnancy in our hospital from Jan.1st,2005 to Aug.30th,2014.Results The incidence of pneumonia complicating pregnancy was 0.035％ in our hospital.In 25 cases of pneumonia complicating pregnancy,3 cases occurred in the first trimester,11 cases occurred in the second trimester,11 cases occurred in the third trimester.There were 11 cases of iron-deficiency anemia.There were 3 cases of spontaneous abortion,3 cases of preterm birth and 19 cases of full-term birth,without neonatal death.The common clinical symptoms were cough,sputum,haemoptysis,stuffy nose,sore throat,fever (38 ℃ at the highest temperature),shortness of breath,chest pain,fatigue and anorexia,shortness of breath was more significant in the second and third trimester.Nursing care on pneumonia patients in the first trimester of pregnancy was identical with non-pregnancy women.Nursing care and medical treatment should be personalized for pneumonia patients in the second and third trimester because of reduced respiratory function.The conditions of patients with iron-deficiency anemia improved and all patients recovered satisfactorily.No maternal or neonatal death was found.Conclusions The impact of pneumonia in pregnancy is significant to mother and fetus accompany with spontaneous abortion or preterm birth.The clinical features of pneumonia are same as non-pregnancy women.Anemia is one of high risk factors of pneumonia in pregnancy.Standard clinical treatment and nursing care are critical for earlier recovery.%目的 探讨妊娠合并肺炎的临床和护理特征,提出规范护理和治疗的建议及预防的措施.方法 对2005年1月1日至2014年8月30日广州医科大学附属第三医院(我院)收治的妊娠合并肺炎病例25例,各项临床特征和护理特点进行回顾性分析.结果 我院妊娠合并肺炎的发生率为0.035％.25例中,早期妊娠合并肺炎3例,中期妊娠合并肺炎11例,晚期妊娠合并肺炎11例.合并缺铁性贫血者11例.25例自然流产和早产的均为3例,足月产19例,无新生儿死亡.患者均出现咳嗽、咳痰、咯血、鼻塞、咽痛、发热(最高体温38℃)、气促、胸痛、乏力、纳差等常见临床症状.其中妊娠中、晚期患者气促更明显.早孕者肺炎护理同非孕期,中晚孕者因呼吸系统功能下降,母体和胎儿缺氧发生率更高,心理护理、生活护理和医疗护理需个体化,11例贫血者好转,全部患者肺炎痊愈出院.无孕产妇和新生儿死亡.结论 妊娠合并肺炎对母胎的影响较大,伴发流产和早产发生率均较高.其临床表现与非孕妇相似,贫血是妊娠合并肺炎的高危因素之一,规范医疗和护理治疗促使病情早日康复的重要环节.