抗磷脂質抗體症候群之周產期照護

Perinatal Care of Women With Anti-Phospholipid Antibody Syndrome

抗磷脂抗體症候群已被證實與反覆性流產、胎兒生長遲滯、早產及嚴重子癇前症有關，但臨床表徵因不同的抗體型態而異，且許多疾病或藥物都可能促發抗體反應，因此確定診斷的過程較為繁複，雖無篩檢效益，但若能儘早發現帶有高濃度抗體的婦女並給予適當的治療，仍可能降低周產期罹病率及死亡率的憾事。有鑒於醫界努力尋求致病機轉及治療之時，護理人員尚未知覺此症之重要性，故本文由抗磷脂抗體症候群之病理機轉、孕婦的孕產結果與治療及罹病婦女可能出現的身心感受等問題的深入探討，並對其照護方式、未來研究及護理教育提出相關建議。

The relationship of Anti-phospholipid Syndrome (APS) with recurrent abortion, fetal growth　retardation, preterm delivery and severe pre-eclampsia has been firmly established. However, the　clinical manifestations vary with different antibody types. Many diseases or medications may induce antibody reaction. It seems that there are no benefits from general screening, but early detection of women with high concentration of anti-phospholipid antibody, and appropriate treatment may reduce perinatal mortality and morbidity. Current medical science has made great efforts in exploring pathogenic mechanism and treatment of APS. In the meantime, nursing caregivers have not perceived the importance of APS. This paper tries to state the pathogenic mechanism of APS, the treatment and the clinical result of pregnant women with APS, as well as the perceptions of women who suffer from APS. Recommendations for nursing care of women with APS, further research and nursing education are also mentioned.