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目的:探讨妊娠晚期合并结核性渗出性胸膜炎的诊断与处理方法。方法:回顾性分析3例妊娠晚期合并结核性渗出性胸膜炎的病例资料。结果:3例患者在发病12天以上仍被误诊为其他疾病者2例;均予胸腔穿刺抽液,并给予有效的抗结核药物治疗,胸腔闭式引流1例;并根据孕妇及胎儿情况适时终止妊娠,其中羊水过少合并早产1例,产后出血1例,均预后良好。结论:妊娠期间出现咳嗽、胸痛、消瘦、低热的患者应当考虑有结核感染的可能,即时胸部X线检查。一旦确诊妊娠合并肺结核应尽快给予抗结核药物治疗;若合并结核性渗出性胸膜炎,B超定位下行胸腔穿刺抽液,必要时行胸腔闭式引流;严格掌握继续妊娠指征,适时终止妊娠。
Objective: To investigate the diagnosis and treatment of tuberculous exudative pleurisy in late pregnancy. Methods: A retrospective analysis of 3 cases of third trimester pregnancy combined tuberculosis exudative pleurisy data. Results: Three patients were still misdiagnosed as other diseases in more than 12 days. Two patients were given thoracentesis and received effective antituberculotic drug therapy. Thoracic drainage was performed in 1 patient. According to the situation of pregnant women and fetus Termination of pregnancy, including oligohydramnios combined with premature labor in 1 case, 1 case of postpartum hemorrhage, a good prognosis. CONCLUSIONS: Patients with cough, chest pain, weight loss and fever during pregnancy should consider the possibility of TB infection with immediate chest radiography. Once diagnosed with tuberculosis in pregnancy should be given antituberculosis drug treatment as soon as possible; if combined with tuberculous exudative pleurisy, B-positioning down chest thoracentesis, if necessary, closed thoracic drainage; strict control of pregnancy indications, timely termination of pregnancy.