4例肾移植术后妊娠的临床病例分析
柳宛璐;李宇琪;乔福元;吴媛媛;
摘要(Abstract)：
目的:探讨肾移植术后妊娠患者的孕期管理及分娩方式。方法:回顾分析4例肾移植术后妊娠患者的妊娠过程、结局、分娩方式和围产儿结局。结果:4例女性患者均接受同种异体肾移植术,分别于术后5～16年成功妊娠。2例患者早孕期超声发现胚胎停止发育。2例患者孕期给予FK506(他克莫司)、美卓乐(甲泼尼松龙片)和依木兰(巯唑嘌呤片)治疗,FK506浓度2～9ng/ml,其中1例患者孕38(+1)周行剖宫产术分娩一活女婴,1例孕35(+1)周行剖宫产术分娩一活女婴,1例孕35(+5)周胎膜早破,早产经阴分娩一活女婴。随访1～2年,婴幼儿均健康。结论:肾移植术后患者本身及胎儿风险较高,应视为高危妊娠。妊娠前应更换合理的免疫抑制方案,孕期监测FK506浓度,精确调整免疫抑制剂及激素剂量,使其药物浓度保持在治疗窗内,确保患者顺利妊娠及分娩。
关键词(KeyWords)： 肾移植;妊娠;分娩方式
基金项目(Foundation):
作者(Authors): 柳宛璐;李宇琪;乔福元;吴媛媛;
DOI: 10.13283/j.cnki.xdfckjz.2019.04.013
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