摘要
目的探讨妊娠期恶性淋巴瘤的化疗与胎儿宫内生长、分娩的相互影响及孕期处理。方法回顾性分析本院1例非霍奇金淋巴瘤（NHL）患者治疗及因特殊原因不能终止妊娠而成功分娩的经过，并以“妊娠”和“恶性淋巴瘤”为主题词于“中国知网”进行文献检索，对自1992年11月-2010年9月国内报道的15例“妊娠合并恶性淋巴瘤”相关病例报道进行研究，分析妊娠期恶性淋巴瘤患者的化疗选择及对胎儿生长、母体结局的影响。结果妊娠期合并恶性淋巴瘤不易早期发现，进展快、侵袭性强、肿瘤负荷大，危及生命；对妊娠及母体的影响，包括流产、早产、胎死宫内及感染出血等。本例患者合并上腔静脉压迫综合征，无法早期结束妊娠，靶向治疗联合化疗后，病变控制缓解，获得成功分娩。结论妊娠合并恶性淋巴瘤经过合理选择治疗，继续妊娠至胎儿成熟分娩，分娩后补充完成化、放疗，可获得良好的妊娠结局及母体生存。治疗对于婴儿的近远期影响在随访观察中。
Objective To examine the impact of chemotherapy for malignant lymphoma during pregnancy and the intrauterine growth of the fetus and pregnancy outcomes. Methods The medical record of a pregnant woman who had non-Hodgkin＇ s lymphoma with a successful delivery in our hospital was reviewed. A search to the CNKI literature database using the keywords of ＂pregnancy＂ and ＂malignant lymphoma＂. Reports of 15 cases of malignant lymphoma-complicated pregnancies were retrieved during November 1992 to September 2010 in China. These reports were reviewed regarding the effects of pregnancy complicated by malignant lymphoma treated with chemotherapy on fetal growth and pregnancy out- comes. Results Malignant lymphoma during pregnancy was difficult to diagnose in early stage, and therefore the malig- nancy advanced rapidly, threatening the lives of the fetus and the mother. Major effects chemotherapy include miscarriage, stillbirth, premature birth, infection, and bleeding. We did not choose early termination in this patient due to evident supe- rior vena cava syndrome, and managed to delivery at 33 weeks of gestation with the relief of the disease with targeted thera- py combined with chemotherapy. Conclusion Malignant lymphoma in pregnancy is life threatening. Good pregnancy outcomes in pregnancies complicated with non-Hodgkin＇s lymphoma could be achieved by radiotherapy and chemotherapy personalized to the patient.
出处
《中国生育健康杂志》
2012年第2期100-104,共5页
Chinese Journal of Reproductive Health
关键词
妊娠
非霍奇金淋巴瘤
化学疗法
Pregnancy
Non-Hodgkin＇ s lymphoma
Chemotherapy
