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相關文獻
- Retinal Detachment in Postpartum Preeclampsia and Eclampsia: Report of Two Cases
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頁籤選單縮合
題名 | Retinal Detachment in Postpartum Preeclampsia and Eclampsia: Report of Two Cases=產後子癇前症之子癇症引發視網膜剝離:二例報告 |
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作者 | 李卓; 許德耀; 歐家佑; 張旭陽; 宋永魁; | 書刊名 | 長庚醫學 |
卷期 | 22:3 1999.09[民88.09] |
頁次 | 頁520-524 |
分類號 | 417.453 |
關鍵詞 | 視網膜剝離; 子癲前症; 子癲症; 產後; Retinal detachment; Preeclampsia; Eclampsia; Postpartum; |
語文 | 英文(English) |
中文摘要 | 視網膜剝離是一罕見的妊娠高血壓併發症。它可發生在產前,生產中及產後。嚴 重子癇前症病人約有1%至2%發生視網膜剝離,而子癇症有10%發生視網膜剝離。一般認 為視網膜剝離是因為脈絡膜缺血。我們知道在正常妊娠時球結膜的小動脈有輕微的痙攣現 象,在妊娠高血壓的病人卻發生嚴重的小動脈痙攣而導致局部缺血。大部份妊娠高血壓引起 的視網膜剝離在幾個星期內自然消褪而不會有後遺症。藥物治療包括降壓藥及類脂醇對病情 也許有幫助。我們報告兩例罕見的產後子癲前症,子癲症引發視網膜剝離的病例。這兩位病 人產前檢查正常,沒有高血壓,糖尿病及其他血管病變的病史。產後發生子癲前症,子癲症 及主訴嚴重視力模糊,視力減退。眼底鏡檢查為視網膜剝離。以上兩位產婦經治療和追蹤檢 查後,視力已恢復,無其他後遺症。因此,產後視網膜剝離可發生在產前有高血壓的產婦, 亦可發生在產前血壓正常的產婦。我們建議對發生視力模糊的產婦不管產前有沒有高血壓都 應儘快做眼底鏡檢查,才能及早診斷和給予降壓藥穩定血壓或給予類脂醇治療。 |
英文摘要 | Retinal detachment is an unusual complication of hypertensive disorder in pregnancy. It has been reported in 1% to 2% of patients with severe preeclampsia and in 10% of patients with eclampsia. Choroidal ischemia may be the cause of retinal detachment. We know that mild arteriolar spasm involving the bulbar conjuntival vessels has been observed in the normal pregnancy, but in pregnancy-induced hypertension the vasospasm may be severe and result in choroidal ischemia. Most patients with retinal detachment in pregnancy-induced hypertension have had full spontaneous resolution within a few weeks, and they did not have any sequelae. Medical treatment with antihypertensive drugs and steroids may be helpful. We report two rare cases of retinal detachment and persistent hypertension in association with postpartum eclampsia and post-cesarean section preeclampsia. These patients had normotension throughout pregnancy. Preeclampsia or eclampsia developed after delivery, and blurred vision, headache, and reduced vision accompanied serous retinal detachment. The serous retinal detachment disappeared within 3 weeks. Good outcomes were found in the follow-up examinations in both of these cases. For women who had been normotensive at the time of delivery and then complained in the postpartum period of blurred vision, headaches, nausea and vomiting, we should consider the possibility of retinal detachment and perform fundoscopy. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。