妊娠合并二尖瓣狭窄孕妇54例的临床分析

发布时间：2018-03-06 16:51

本文选题：二尖瓣狭窄　切入点：心血管　出处：《中国妇产科临床杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的探讨妊娠合并二尖瓣狭窄的孕妇在妊娠期的临床处理方法和母儿安全性。方法回顾性分析2008年1月至2016年2月首都医科大学附属北京安贞医院54例妊娠合并二尖瓣狭窄的孕妇的临床资料,包括孕周、二尖瓣狭窄程度、孕期的管理和治疗及母儿结局。结果 (1)临床特点:54例患者中轻度狭窄9例,中度狭窄10例,重度狭窄35例,年龄25~34岁,发病孕周12~38周,临床表现:二尖瓣面容,劳力性呼吸困难,听诊舒张期隆隆样杂音,二尖瓣型P波;心脏并发症:肺动脉高压、心律失常、肺水肿、心内膜炎、心力衰竭、死亡等;(2)重度狭窄与轻、中度狭窄在孕妇心脏并发症和胎儿/新生儿并发症的差异有统计学意义(P0.05);(3)二尖瓣狭窄的孕妇中轻度和中度狭窄,通过药物治疗,重度二尖瓣狭窄需经皮介入性球囊扩张术和心脏外科手术治疗。结论妊娠合并二尖瓣狭窄,特别是重度二尖瓣狭窄,应孕前咨询,及时干预,可改善母儿预后。
[Abstract]:Objective to investigate the clinical management and maternal and fetal safety of pregnant women with mitral stenosis during pregnancy. Methods 54 cases of pregnancy in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2008 to February 2016 were retrospectively analyzed. Clinical data of pregnant women with mitral stenosis, Results 1) Clinical features: 9 cases of mild stenosis, 10 cases of moderate stenosis, 35 cases of severe stenosis, age 250-34 years, onset of gestational age 1238 weeks, clinical features of 9 cases of mild stenosis, 10 cases of moderate stenosis, 35 cases of severe stenosis, and the management and treatment of mitral valve stenosis during pregnancy and pregnancy. Clinical manifestations: mitral valve appearance, exertional dyspnea, auscultation diastolic rumbling murmur, mitral valve P wave, cardiac complications: pulmonary hypertension, arrhythmia, pulmonary edema, endocarditis, heart failure, There was significant difference between severe stenosis and mild and moderate stenosis in pregnant women and fetal / neonatal complications. There was a significant difference between severe stenosis and mild or moderate stenosis in pregnant women with mitral stenosis, and the difference was statistically significant in pregnant women with fetal / neonatal complications (P < 0.05). The patients with mitral stenosis had mild and moderate stenosis and were treated with drugs. Conclusion pregnancy complicated with mitral stenosis, especially severe mitral stenosis, should be treated with pre-pregnancy consultation and timely intervention, which can improve the prognosis of mother and infant.
【作者单位】：首都医科大学附属北京安贞医院妇产科;首都医科大学附属北京安贞医院心脏科;

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