中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
3期
382-384
,共3页
妊娠%肺动脉高压%先天性心脏病
妊娠%肺動脈高壓%先天性心髒病
임신%폐동맥고압%선천성심장병
Pregnancy%Pulmonary hypertension%Congenital heart disease
目的 探讨妊娠合并心脏病伴肺动脉高压患者的妊娠结局及治疗.方法收集2009年 9月至2012年7月北京安贞医院妇产科收治的38例妊娠合并心脏病伴肺动脉高压患者的临床资料,根据肺动脉压力分为轻度组(13例)、中度组(10例)和重度组(15例),分析各组心脏病种类、心功能情况、妊娠周数、终止妊娠方式及母婴结局.结果 ①妊娠合并心脏病伴肺动脉高压患者中,先天性心脏病患者占94.7%(36/38),风湿性心脏病仅占5.3%(2/38).②轻、中度组心功能Ⅰ～Ⅱ级者为主(分别为13、8例);重度组心功能以Ⅲ～Ⅳ级为主(共11例),有2例患者死亡.轻度组与重度组比较差异有统计学意义(P<0.05).③低氧血症患者轻度组1例,中度组0例,重度组6例,3组间比较差异无统计学意义(P>0.05).④分娩方式以剖宫产为主,占89.5%(34/38),麻醉方式以连续硬膜外或腰麻为主,占94.1%(32/34).⑤足月分娩:轻度组明显多于重度组(分别为11、6例),差异有统计学意义(P<0.05).⑥新生儿体重:轻度组明显高于重度组[分别为(3 141±98)、(2 374±92)g],差异有统计学意义(P<0.05).⑦低出生体重儿:重度组明显多于轻度组(分别为8、1例),差异有统计学意义(P<0.05).结论 妊娠合并心脏病伴肺动脉高压患者的肺动脉压越高,母婴妊娠结局越差;剖宫产是比较安全的分娩方式.
目的 探討妊娠閤併心髒病伴肺動脈高壓患者的妊娠結跼及治療.方法收集2009年 9月至2012年7月北京安貞醫院婦產科收治的38例妊娠閤併心髒病伴肺動脈高壓患者的臨床資料,根據肺動脈壓力分為輕度組(13例)、中度組(10例)和重度組(15例),分析各組心髒病種類、心功能情況、妊娠週數、終止妊娠方式及母嬰結跼.結果 ①妊娠閤併心髒病伴肺動脈高壓患者中,先天性心髒病患者佔94.7%(36/38),風濕性心髒病僅佔5.3%(2/38).②輕、中度組心功能Ⅰ～Ⅱ級者為主(分彆為13、8例);重度組心功能以Ⅲ～Ⅳ級為主(共11例),有2例患者死亡.輕度組與重度組比較差異有統計學意義(P<0.05).③低氧血癥患者輕度組1例,中度組0例,重度組6例,3組間比較差異無統計學意義(P>0.05).④分娩方式以剖宮產為主,佔89.5%(34/38),痳醉方式以連續硬膜外或腰痳為主,佔94.1%(32/34).⑤足月分娩:輕度組明顯多于重度組(分彆為11、6例),差異有統計學意義(P<0.05).⑥新生兒體重:輕度組明顯高于重度組[分彆為(3 141±98)、(2 374±92)g],差異有統計學意義(P<0.05).⑦低齣生體重兒:重度組明顯多于輕度組(分彆為8、1例),差異有統計學意義(P<0.05).結論 妊娠閤併心髒病伴肺動脈高壓患者的肺動脈壓越高,母嬰妊娠結跼越差;剖宮產是比較安全的分娩方式.
목적 탐토임신합병심장병반폐동맥고압환자적임신결국급치료.방법수집2009년 9월지2012년7월북경안정의원부산과수치적38례임신합병심장병반폐동맥고압환자적림상자료,근거폐동맥압력분위경도조(13례)、중도조(10례)화중도조(15례),분석각조심장병충류、심공능정황、임신주수、종지임신방식급모영결국.결과 ①임신합병심장병반폐동맥고압환자중,선천성심장병환자점94.7%(36/38),풍습성심장병부점5.3%(2/38).②경、중도조심공능Ⅰ～Ⅱ급자위주(분별위13、8례);중도조심공능이Ⅲ～Ⅳ급위주(공11례),유2례환자사망.경도조여중도조비교차이유통계학의의(P<0.05).③저양혈증환자경도조1례,중도조0례,중도조6례,3조간비교차이무통계학의의(P>0.05).④분면방식이부궁산위주,점89.5%(34/38),마취방식이련속경막외혹요마위주,점94.1%(32/34).⑤족월분면:경도조명현다우중도조(분별위11、6례),차이유통계학의의(P<0.05).⑥신생인체중:경도조명현고우중도조[분별위(3 141±98)、(2 374±92)g],차이유통계학의의(P<0.05).⑦저출생체중인:중도조명현다우경도조(분별위8、1례),차이유통계학의의(P<0.05).결론 임신합병심장병반폐동맥고압환자적폐동맥압월고,모영임신결국월차;부궁산시비교안전적분면방식.
Objective To discuss the treatment of pregnancy with heart disease and pulmonary hypertension. Methods Totally 38 cases of pregnancy with heart disease and pulmonary hypertension were collected from September 2009 to July 2012. According to pulmonary arterial pressure, the patients were divided into 3 groups,including 13 mild cases, 10 morderate cases and 15 severe cases. The type of heart disease, cardiac function, gestational weeks,ways to terminate pregnancy and outcomes of infant and mother were analyzed. Results ①Of all the cases, the proportion of congenital disease was 94.7(36/38); rheumatic heart disease was 5.3%(2/38). ②In mild and moderate groups, most were cardiac function grade Ⅰ toⅡ(13 cases and 8 cases). In severe group, most were cardiac function grade Ⅲ toⅣ(11 cases) and two patients die. There was statistical significance between mild group and severe group. ③There was one hyoxemia patient in mild group, zero hyoxemia patient in morderate group and six hyoxemia patients in severe group. There was no statistical significance among three groups. ④The majority end pregnancy in cesarean section way[89.5%(34/38)].The major anesthesia way was lumbar anesthesia and continual epidural anesthesia[94.1%(32/34)]. ⑤Term birth in mild group were obviously more than that in severe group(11 cases vs 6 cases). ⑥Neonatal weight of mild group was more than that of severe group[(3 141±98)g vs (2 374±92)g]. ⑦Low birth weight infants in severe group were more than those mild group(8 cases vs 1 case). Conclusions The higher pulmonary arterial pressure brings the worse outcome of infant and mother. Cesarean section is a safe way to end pregnancy for pregnancy with heart disease with pulmonary hypertension.
