现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
16期
2417-2419
,共3页
妊娠%心脏病%心力衰竭
妊娠%心髒病%心力衰竭
임신%심장병%심력쇠갈
Pregnancy%Heart Diseases%Heart Failure
目的：探讨妊娠期心脏病患者发生心力衰竭的孕期处理、分娩时机的选择及其对母婴预后的影响。方法回顾性分析2011年1月至2013年4月156例妊娠期心脏病患者的发病情况、心力衰竭发生率及治疗方法、分娩方式与时机等资料。结果156例妊娠期心脏病患者中87例（55.8%）发生心力衰竭，其中中、重度心力衰竭38例（43.7%）；发生心力衰竭的87例患者中，有明显诱因52例（59.8%），其中肺部感染12例，上呼吸道感染15例，贫血8例，精神紧张8例，血压升高6例，分娩时用力过大3例；心功能Ⅰ~Ⅱ级孕产妇与心功能Ⅲ~Ⅳ级孕产妇分娩孕周、分娩方式和新生儿情况比较，差异均有统计学意义（P<0.05或0.01）。结论妊娠期心脏病合并心力衰竭危及母婴生命，应积极治疗原发病，去除诱因，孕期密切监测心功能，麻醉以连续性硬膜外麻醉为宜，孕晚期经过有丰富经验的内、产科医生积极治疗24~72 h后可及时终止妊娠，有利于孕妇和围生儿的预后。
目的：探討妊娠期心髒病患者髮生心力衰竭的孕期處理、分娩時機的選擇及其對母嬰預後的影響。方法迴顧性分析2011年1月至2013年4月156例妊娠期心髒病患者的髮病情況、心力衰竭髮生率及治療方法、分娩方式與時機等資料。結果156例妊娠期心髒病患者中87例（55.8%）髮生心力衰竭，其中中、重度心力衰竭38例（43.7%）；髮生心力衰竭的87例患者中，有明顯誘因52例（59.8%），其中肺部感染12例，上呼吸道感染15例，貧血8例，精神緊張8例，血壓升高6例，分娩時用力過大3例；心功能Ⅰ~Ⅱ級孕產婦與心功能Ⅲ~Ⅳ級孕產婦分娩孕週、分娩方式和新生兒情況比較，差異均有統計學意義（P<0.05或0.01）。結論妊娠期心髒病閤併心力衰竭危及母嬰生命，應積極治療原髮病，去除誘因，孕期密切鑑測心功能，痳醉以連續性硬膜外痳醉為宜，孕晚期經過有豐富經驗的內、產科醫生積極治療24~72 h後可及時終止妊娠，有利于孕婦和圍生兒的預後。
목적：탐토임신기심장병환자발생심력쇠갈적잉기처리、분면시궤적선택급기대모영예후적영향。방법회고성분석2011년1월지2013년4월156례임신기심장병환자적발병정황、심력쇠갈발생솔급치료방법、분면방식여시궤등자료。결과156례임신기심장병환자중87례（55.8%）발생심력쇠갈，기중중、중도심력쇠갈38례（43.7%）；발생심력쇠갈적87례환자중，유명현유인52례（59.8%），기중폐부감염12례，상호흡도감염15례，빈혈8례，정신긴장8례，혈압승고6례，분면시용력과대3례；심공능Ⅰ~Ⅱ급잉산부여심공능Ⅲ~Ⅳ급잉산부분면잉주、분면방식화신생인정황비교，차이균유통계학의의（P<0.05혹0.01）。결론임신기심장병합병심력쇠갈위급모영생명，응적겁치료원발병，거제유인，잉기밀절감측심공능，마취이련속성경막외마취위의，잉만기경과유봉부경험적내、산과의생적겁치료24~72 h후가급시종지임신，유리우잉부화위생인적예후。
Objective To investigate the treatment of heart failure of cardiac patients during pregnancy ,the time of de-livery and the influence on prognosis of mothers and infants. Methods Retrospective analysis was conducted among 156 preg-nant women with heart disease from January 2011 to April 2013 on the occurrence status ,incidence rate and therapeutic method of hear failure,delivery way,delivery time and so on. Results Among the 156 pregnant patients,heart failure occurred in 87 cases(55.8%),including 38 cases of moderately severe heart failure(43.7%);among the 87 heart failure patients,52 cases had dis tinct inducement(59.8%),including 12 cases with lung infection,15 cases with upper respiratory tract infection,8 cases with anemia,8 cases with psychentonia,6 cases with elevation of blood pressure and the other 3 cases with excessive force during de-livery;the comparison on gestational weeks ,delivery mode and newborn condition between the pregnant women with GradeⅠ-Ⅱof cardiac function and the women with GradeⅢ-Ⅳhad statistically significant difference(P<0.05 or 0.01). Conclusion Heart failure during pregnancy endangers the lives of mother and infant ,so active treatment of the primary disease should be conducted to remove inducements and monitor the cardiac function closely;continuous epidural anesthesia is appropriate choice ,active treat-ment from experienced physician and obstetrician for 24-72 h at third trimester can terminate the pregnancy timely ,which is benifical to the prognosis of pregnancy and perinatal infants.
