CAJ | 학술논문

目的：研究胎儿心律失常的影响因素及预后，为临床工作提供科学依据。方法回顾性分析2011年8月至2014年7月本院住院孕产妇在门诊或住院期间胎儿心电图检查情况，并对诊断为胎儿心律失常者的临床资料进行分析。结果①住院孕产妇中0．22％（67／29853）发生胎儿心律失常，其中，胎儿心动过速19例（28．4％）；胎儿心动过缓4例（6．0％）；胎儿心律不齐11例（16．4％）；胎儿室上性早搏31例（46．3％）；胎儿室性早搏2例（3．0％）。②胎儿心律失常的影响因素以胎儿心脏结构异常、胎儿宫内窘迫及脐带异常为主，分别占26．8％、20．8％和17．9％。③67例胎儿心律失常中有5例经保守治疗胎儿心律恢复正常后继续妊娠；不愿承担风险自愿选择引产者4例；58例孕妇随访至分娩后1周，分娩者中新生儿心电图异常者8例，50例转归正常的新生儿预后良好。采用Fisher精确概率法分析胎儿心律失常类型与预后，差别无统计学意义（ P＝0．165）。结论胎儿心律失常类型及影响因素多样，应根据具体类型采取个体化处理方案，胎儿心律失常各类型的预后没有差别。胎儿心律失常合并有心脏严重畸形时，提示预后不良，需要积极进行临床干预。
목적：연구태인심률실상적영향인소급예후，위림상공작제공과학의거。방법회고성분석2011년8월지2014년7월본원주원잉산부재문진혹주원기간태인심전도검사정황，병대진단위태인심률실상자적림상자료진행분석。결과①주원잉산부중0．22％（67／29853）발생태인심률실상，기중，태인심동과속19례（28．4％）；태인심동과완4례（6．0％）；태인심률불제11례（16．4％）；태인실상성조박31례（46．3％）；태인실성조박2례（3．0％）。②태인심률실상적영향인소이태인심장결구이상、태인궁내군박급제대이상위주，분별점26．8％、20．8％화17．9％。③67례태인심률실상중유5례경보수치료태인심률회복정상후계속임신；불원승담풍험자원선택인산자4례；58례잉부수방지분면후1주，분면자중신생인심전도이상자8례，50례전귀정상적신생인예후량호。채용Fisher정학개솔법분석태인심률실상류형여예후，차별무통계학의의（ P＝0．165）。결론태인심률실상류형급영향인소다양，응근거구체류형채취개체화처리방안，태인심률실상각류형적예후몰유차별。태인심률실상합병유심장엄중기형시，제시예후불량，수요적겁진행림상간예。
Objective To investigate the influencing factors of fetal arrhythmia and its progno-sis, and provide scientific basis for clinical work .Methods The clinical data of fetal electrocardio-gram(FECG) were retrospectively studied, which came from pregnant women in hospital as outpa-tients or inpatients examined from August 2011 to July 2014 our hospital .Further analysis was car-ried out on data diagnosed with fetal arrhythmia .Results (ⅰ) A total of 67 fetal arrhythmia were detected , with an incidence rate of 0 .22%( there were 29 853 deliveries during the study period ) . Among the 67 cases with fetal arrhythmia, there were 19 cases (28.4%) with fetal tachycardia, 4 cases ( 6 .0%) with fetal tachycardia , 11 cases ( 16 .4%) with fetal arrhythmia , 31 cases (46.3%) with fetal supraventricular premature beat , and 2 cases (3.0%) with fetal ventricular premature beat .(ⅱ) The influencing factors of fetal arrhythmia were mainly cardiac structural ab-normalities, fetal distress, and umbilical cord abnormalities , accounting for 26.8%, 20.8% and 17 .9%, respectively .(ⅲ) Among 67 cases with fetal arrhythmia , 5 cases received conservative treatment and continued pregnancy after fetal heart rhythm returned to be normal; Four cases were unwilling to take risk and voluntarily chose odinopoeia; Fifty-eight cases of pregnant women were followed up till one week after delivery , among whom neonatus ECG abnormalities were detected in 8 cases, and 50 cases had favorable prognosis .By Fisher exact probability test , it indicated that no statistically significant difference was found in the prognosis of cases with different types of fetal ar -rhythmia (P=0.165).Conclusion For the diversity of fetal arrhythmia types and influencing fac-tors, individualized therapy and treatment options should be taken according to specific types .There was no statistically significant difference in the prognosis of cases with different types of fetal arrhyth-mia.It indicates unfavorable prognosis if fetal arrhythmia is accompanied with serious cardiac mal-formation .Positive clinical intervention is required in this case .