12例中晚期妊娠合并主动脉夹层的临床分析

发布时间：2018-06-27 14:49

本文选题：主动脉夹层 + 妊娠　；参考：《实用妇产科杂志》2015年06期

【摘要】：目的:探讨中晚期妊娠合并主动脉夹层的治疗方法对母儿结局的影响。方法:回顾性分析2008年1月至2014年10月首都医科大学附属北京安贞医院12例中晚期妊娠合并主动脉夹层患者的临床资料。结果:12例患者中2例因拒绝手术死亡;10例患者接受外科手术治疗,其中9例存活,1例死于手术并发症。5例Stanford A型患者接受了剖宫产或剖宫取胎术联合主动脉修复或置换手术治疗,其中1例为妊娠中期病例,其他4例为妊娠晚期病例。1例Stanford A型和2例Stanford B型病例在妊娠中期终止妊娠后行主动脉手术。1例Stanford A型和1例Stanford B型在妊娠中期病例接受主动脉手术后继续妊娠,术后Stanford A型病例妊娠至孕31周发生死胎,Stanford B型病例因子痫前期于孕30周终止妊娠。胎儿结局:死胎3例,剖宫取胎术3例,早产5例,足月产1例。6例新生儿均存活。结论:在妊娠晚期同时行剖宫产和主动脉修复或置换手术,胎儿可以获得良好结局。
[Abstract]:Objective: to investigate the effect of treatment of middle and late pregnancy with aortic dissection on maternal and fetal outcomes. Methods: from January 2008 to October 2014, the clinical data of 12 patients with aortic dissection in Beijing Anzhen Hospital affiliated to Capital Medical University were retrospectively analyzed. Results of 12 patients, 2 died of rejection and 10 received surgical treatment. One patient died of surgical complications. 5 patients with Stanford A received caesarean section or hysterectomy combined with aortic repair or replacement. One of them was in the second trimester of pregnancy. The other 4 cases were late pregnancy cases (.1 cases of Stanford A and 2 cases of Stanford B) undergoing aortic surgery after the second trimester of pregnancy, and one case of type Stanford B continued pregnancy after aortic operation in the second trimester of pregnancy. Postoperatively, the type A pregnancy ended at 30 weeks due to preeclampsia, and the stillbirth occurred at 31 weeks after pregnancy. Fetal outcome: stillbirth in 3 cases, cesarean section in 3 cases, premature delivery in 5 cases, and full-term delivery in 1 case (6 cases). Conclusion: caesarean section and aortic replacement are performed simultaneously in the third trimester of pregnancy.
【作者单位】：首都医科大学附属北京安贞医院;
【分类号】：R714.252

【共引文献】