国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2009年
6期
16-19
,共4页
妊娠%心脏病%心力衰竭%手术时机
妊娠%心髒病%心力衰竭%手術時機
임신%심장병%심력쇠갈%수술시궤
Pregnancy%Heart disease%Heart failure%Time of termination
目的 探讨妊娠合并心力衰竭(心衰)的孕期处理、分娩时机的选择及其对母婴预后的影响.方法 回顾性分析356例奸娠期心脏病患者的发病情况、心衰的发生率、治疗效果、分娩方式与时机等资料.结果 356例妊娠期心脏病中有136例(38.20%)发生心衰,其中中重度心衰76例(55.88%);风湿性心脏病(风心病)较先天性心脏病(先心病)易发生心衰;孕前未行心脏手术治疗的风心病患者较先心病易发生心衰,孕前已行心脏手术治疗的风心病孕妇中重度心衰发生率明显较孕前未行手术治疗者下降(P＜0.05);孕期心衰控制良好组与不良组比较,前者对妊娠、分娩的耐受性好,能顺利度过妊娠、分娩、产褥期.结论 风心病和先心病是妊娠期心力衰竭的主要原因,孕前特别是风心病患者行心脏手术治疗,可显著改善妊娠期心功能,妊娠期密切监视心功能,妊娠晚期控制心衰后及时终止妊娠,有利于孕妇和围产儿的预后.
目的 探討妊娠閤併心力衰竭(心衰)的孕期處理、分娩時機的選擇及其對母嬰預後的影響.方法 迴顧性分析356例姦娠期心髒病患者的髮病情況、心衰的髮生率、治療效果、分娩方式與時機等資料.結果 356例妊娠期心髒病中有136例(38.20%)髮生心衰,其中中重度心衰76例(55.88%);風濕性心髒病(風心病)較先天性心髒病(先心病)易髮生心衰;孕前未行心髒手術治療的風心病患者較先心病易髮生心衰,孕前已行心髒手術治療的風心病孕婦中重度心衰髮生率明顯較孕前未行手術治療者下降(P＜0.05);孕期心衰控製良好組與不良組比較,前者對妊娠、分娩的耐受性好,能順利度過妊娠、分娩、產褥期.結論 風心病和先心病是妊娠期心力衰竭的主要原因,孕前特彆是風心病患者行心髒手術治療,可顯著改善妊娠期心功能,妊娠期密切鑑視心功能,妊娠晚期控製心衰後及時終止妊娠,有利于孕婦和圍產兒的預後.
목적 탐토임신합병심력쇠갈(심쇠)적잉기처리、분면시궤적선택급기대모영예후적영향.방법 회고성분석356례간신기심장병환자적발병정황、심쇠적발생솔、치료효과、분면방식여시궤등자료.결과 356례임신기심장병중유136례(38.20%)발생심쇠,기중중중도심쇠76례(55.88%);풍습성심장병(풍심병)교선천성심장병(선심병)역발생심쇠;잉전미행심장수술치료적풍심병환자교선심병역발생심쇠,잉전이행심장수술치료적풍심병잉부중중도심쇠발생솔명현교잉전미행수술치료자하강(P＜0.05);잉기심쇠공제량호조여불량조비교,전자대임신、분면적내수성호,능순리도과임신、분면、산욕기.결론 풍심병화선심병시임신기심력쇠갈적주요원인,잉전특별시풍심병환자행심장수술치료,가현저개선임신기심공능,임신기밀절감시심공능,임신만기공제심쇠후급시종지임신,유리우잉부화위산인적예후.
Objective To explore the management of heart failure, the timing of delivery in pregnancy, and the influencce on pregnant prognosis. Methods We retrospectively analyzed the incidence of heart failure,treatment results, pattern of termination, and time of termination in 356 cases of pregnancy with heart disease.Results One hundred and thirty-six(38.20%) cases were diagnosed as heart failure and 76(55.88%) were moderate or severe heart failure. Heart failure tensd to occur more easily in rheumatic heart diseases than in congenital heart diseases. Heart failure occurred more ferquently in pregnancy with rheumatic heart diseases without the heart opeartion before pregnancy than that of pregnancy with congenital heart diseases. The occurrence of the moderate and severe heart failure in pregnancy decreased in rheumatic heart diseases with surgical therapies compared with those without surgical therapise(P< 0.05). Compatred with pregnancy with heart failure controlled inadequately,pregnancy with effectively controlled heart failure had better tolerance during delivery and through the pregnancy,and puerperium. Conclusions Congenital heart diseases and rheumatic heart diseases are the chiefcanses of heart failure during the gestation. Therapy before pregnancy, especially surgery to the rhumatic heart diseases, may improve the cardiac function during pregnancy. Monitoring heart function and selecting the proper timing to terminate pregnancy after controlling the heart failure in late pregnant period will be helpful to improve the prognosis of pregnant and perineonate.
