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目的探讨系统性红斑狼疮(SLE)患者适宜的妊娠时机及终止妊娠的时机。方法回顾性分析我院2003-2008年共28例SLE患者妊娠结局,选择适宜的妊娠时机及终止妊娠的时机。结果28例SLE患者分为两组:选择性妊娠组22例患者,在病情控制1年以上(缓解期)妊娠;非选择性妊娠组6例,其中3例患者在病情活动期未经医生同意自行妊娠,3例患者妊娠期首发SLE。两组患者共分娩活婴24例,无一例新生儿死亡,未发现新生儿狼疮,其中早产儿9例,胎儿生长受限3例。结论SLE患者妊娠期给予适当合理的药物治疗,并加强监护,在病情缓解期选择性妊娠,其安全性明显提高。在药物治疗无好转威胁母婴安全情况下,或胎儿已成熟时,应适时终止妊娠,可以减少并发症的发生,提高妊娠成功率及围产儿存活率。
Objective To investigate the appropriate timing of pregnancy and termination of pregnancy in patients with systemic lupus erythematosus (SLE). Methods A retrospective analysis of 2003-2008 in our hospital a total of 28 cases of SLE patients with pregnancy outcome, select the appropriate timing of pregnancy and termination of pregnancy. Results Twenty-eight patients with SLE were divided into two groups: 22 pregnant women in selective pregnancy group, whose pregnancy was controlled for more than 1 year (remission); 6 non-selective pregnancy group, 3 of whom were not approved by their physician Self-pregnancy, 3 cases of patients with first trimester SLE. Twenty-four live births occurred in both groups. No newborns died and no newborn lupus was found. Among them, 9 were premature children and 3 were fetal growth restriction. Conclusion SLE patients with appropriate and reasonable medication during pregnancy, and strengthen supervision, in the remission of selective pregnancy, the safety was significantly improved. In the absence of improvement in drug treatment threatening the safety of mothers and children, or when the fetus has matured, termination of pregnancy should be timely, can reduce the incidence of complications and improve the success rate of pregnancy and perinatal survival.