精神疾病患者孕产期治疗探讨

目的：探讨精神疾病患者孕产期治疗方法。方法：回顾性分析1999年1月至2007年4月期间足月妊娠分娩的192例精神疾病患者的临床资料。结果：68例发作期的患者分娩时，剖宫产38例（56、7％），其中无产科原因而因精神症状剖宫产20例（29.9％）；稳定期患者124例，剖宫产38例（30．6％），99例妊娠中晚期坚持服抗精神病药，新生儿出生情况良好，未见畸形。结论：精神疾病患者孕中晚期抗精神病药维持治疗很有必要，对发作期的患者分娩时适当放宽剖宫产指征，以保障母婴安全；产后及时、足量恢复抗精神病药使用。

Management of psychotic patient during pregnancy and parturition

Objective:To explore better management in patient with psychotic problems during pregnancy and parturition.Method:Analyzing retrospectively the clinic case of 192 psychotic patients who gave birth to a full-term child in our hospital from January 1999 to April 2007. Results:Of 68 patient in paroxysm,38 patients gave birth through caesarean operation(56.7%) and 20 of them not because of the iatrical caesarean operation index but because of their mental disorders(29.9%);of 124 patients in stationary phase,38 patients gave birth through caesarean operation(30.6%),99 patients persisted in taking antipsychotics during medium and later period of pregnancy and the neonate was in good condition,no abnormality observed.Conclusion:It is necessary for psychotic patient in medium and later period of her pregnancy to keep antipsychotics therapy.For patients in paroxysm,in order to ensure the safety of mother and the child,the indication for caesarean operation could be more flexibly.Sufficient antipsychotic should be resumed in time after parturition.