妊娠合并急性主动脉夹层围产期诊治的临床病例研究

发布时间：2018-03-07 12:21

本文选题：妊娠　切入点：主动脉夹层　出处：《现代妇产科进展》2017年07期 　论文类型：期刊论文

【摘要】：目的:分析妊娠合并急性主动脉夹层患者的围产期诊治方法并总结经验。方法:回顾分析2006年5月至11月华中科技大学同济医学院附属同济医院收治的4例妊娠合并急性主动脉夹层患者的临床资料。1例于全麻下行剖宫产+全主动脉弓置换+降主动脉支架置入术(Bentall手术)。1例于剖宫产术后3天行Bentall手术;1例于剖宫产术后2+月行腹主动脉置换术;1例行剖宫产+主动脉夹层腔内置换术。4例患者均保留子宫,3例新生儿存活。结果:术后6个月随访,3例产妇行计算机断层血管造影术(CTA)检查提示主动脉夹层假腔血栓机化形成;1例产妇出院不足1月未复查。4例产妇术后恢复佳,3例存活婴儿发育正常,1例新生儿死亡。结论:CTA及心脏彩超对及时准确地诊断妊娠合并主动脉夹层至关重要。术中及术后应保证母体血流动力学平稳。应根据孕周及主动脉夹层类型等多方面因素决定终止妊娠的时机及手术方式。
[Abstract]:Objective: to analyze the perinatal diagnosis and treatment of pregnancy complicated with acute aortic dissection. Methods: from May 2006 to November, 4 cases of pregnancy treated in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology were analyzed retrospectively. Clinical data of 1 patients with acute aortic dissection undergoing cesarean section with total aortic arch replacement descending aortic stenting. 1 case underwent Bentall operation 3 days after cesarean section and 1 case 2 days after cesarean section. Abdominal aortic replacement was performed in 1 case of caesarean section and endovascular replacement of aortic dissection in all the 4 cases. Results: 3 cases of newborns were followed up 6 months after operation with computed tomographic angiography (CTAs). The results showed that one case of aortic dissection with pseudo-lumen thrombus was formed in one case and one case was not re-examined in January. 4 cases had recovered after operation. 3 cases of survival infant normal development and 1 case of neonatal death. Conclusion\\% CTA and color Doppler echocardiography are timely and accurate in the diagnosis of aortic dissection. The diagnosis of pregnancy with aortic dissection is very important. The stable maternal hemodynamics should be ensured during and after operation. The timing and operation mode of termination of pregnancy should be determined according to various factors such as gestational age and type of aortic dissection.
【作者单位】：华中科技大学同济医学院附属同济医院妇产科;
【分类号】：R714.252

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