孕产妇合并急性肾衰10例临床分析

目的 探讨孕产妇合并急性肾衰的主要原因及预防和治疗的方法。方法 回顾性分析近三年间孕产妇合并急性肾衰的十例患者的临床资料、诊治情况及母婴预后。结果 孕产妇合并急性肾衰的病因为肾前性衰竭和肾实质性衰竭的占40％。主要的产科并发症为重度子痫前期、产后出血。内科合并症为：急性肝炎、糖尿病、心脏病、中毒性休克。本组病例发病的社会因素包括：文化程度低、社会经济地位较低。其中无规则产检8人，规则产检1人，宫外孕1人。与非法行医相关2人。预防应加强围产保健，治疗包括及时终止妊娠，处理产科并发症，治疗内科疾病，以及对症支持治疗及血液透析治疗。预后均较好。结论 孕产妇合并急性肾衰是妇产科少见而危急的疾病。其病因复杂。应加强产检，及时处理产科并发症和内科合并症，以预防为主。血液透析是治疗急性肾衰的关键。

Acute renal failure in pregnant and postpartum women

Objective To investigate the pregnant and postpartum women who amalgamated acute renal failure(ARF),and discuss its prevention and treatment. Methods ARF in pregnant and postpartum women during the past 3 years was reviewed retrospectively. The clinical features of ARF including the personal date and the methods of diagnosis, treatment and prognosis of pregnant and postpartum women were studied. Results There were 40% ARF in pregnant and postpartum women comprised two factors prerenal and parenchymatous acute renal failure .The main obstetrical disorders included serious pre-eclampsia, postpartum hemorrhage. The medical complication included acute hepatitis, chronic hepatitis, diabetes, heart disease and poisoning shock., The social factors included few education; lower social economic position. There were 8 women had not regular antenatal care; only 1 woman was periodical examination. And 1 woman was an ectopic pregnancy; 2 cases were concern practice transgressed against laws. The focal point is strengthening regular antenatal care, treating the obstetrical disorders and the medical complication, stopping pregnancy in necessary are the treatment. Patient needs supporting treatment and haemodialysis. Outcomes were good in all eases. Conclusions ARF is an uncommon and severe complication in pregnant and postpartum women. Its pathogeny is complex. Prevention is the primary treatment. Haemodialysis is also a key.