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目的探讨妊娠合并心脏病患者不同心功能状态对孕妇及围产儿的影响。方法采用回顾性调查的方法,选取本院2011年1月-2013年6月妊娠合并心脏病孕产妇127例,分析孕产妇分娩情况,胎儿和新生儿的生长、并发症等各项指标。结果Ⅲ~Ⅳ级产妇平均分娩孕周(36.07±5.48周)与Ⅰ~Ⅱ级(38.91±7.25周)比较,差异有统计学意义(P<0.05);Ⅲ~Ⅳ级顺产为25.45%(14/55),低于Ⅰ~Ⅱ级44.44%(32/72),差异有统计学意义(P<0.05);Ⅲ~Ⅳ级终止妊娠为20.00%(11/55),高于Ⅰ~Ⅱ级,差异有统计学意义(P<0.05);Ⅲ~Ⅳ级产妇心衰为27.27%(15/55),高于Ⅰ~Ⅱ级2.78%(2/72),差异有统计学意义(P<0.05)。Ⅲ~Ⅳ级新生儿平均体重为(2 517.83±260.27)g,明显低于Ⅰ~Ⅱ级(3 201.54±322.42)g,差异有统计学意义(P<0.05);Ⅲ~Ⅳ级新生儿窒息、早产儿和围生儿死亡分别为34.55%(19/55)、29.09%(16/55)和10.90%(6/55),均高于Ⅰ~Ⅱ级,差异有统计学意义(P<0.05)。结论妊娠合并心脏病患者心脏功能状态与产妇及围产儿结局密切相关,孕产妇心功能越低,早产发生率增高,孕产妇和新生儿并发症增加,新生儿预后较差。应加强监护和治疗,减少孕妇及新生儿的并发症,提高存活率。
Objective To investigate the effect of different cardiac function in pregnant women with heart disease on pregnant women and perinatals. Methods A retrospective survey was conducted to select 127 pregnant women with heart disease complicated by pregnancy in our hospital from January 2011 to June 2013 and to analyze the indicators of maternal labor, growth and complications of fetus and newborn. Results The average gestational weeks of pregnant women with grade Ⅲ ~ Ⅳ were (36.07 ± 5.48 weeks) and Ⅰ ~ Ⅱ grades (38.91 ± 7.25 weeks), the difference was statistically significant (P <0.05); Ⅲ ~ Ⅳ grade was 25.45% (14.4% / 55), which was lower than 44.44% (32/72) in grade Ⅰ ~ Ⅱ, the difference was statistically significant (P0.05); the level of termination of pregnancy in grade Ⅲ ~ Ⅳ was 20.00% (11/55) , The difference was statistically significant (P <0.05); Ⅲ ~ Ⅳ grade maternal heart failure was 27.27% (15/55), higher than Ⅰ ~ Ⅱ grade 2.78% (2/72), the difference was statistically significant (P < 0.05). The average body weight of grade Ⅲ ~ Ⅳ neonates was (2 517.83 ± 260.27) g, which was significantly lower than that of grade Ⅰ ~ Ⅱ (3 201.54 ± 322.42) g, the difference was statistically significant (P0.05) , Premature infant and perinatal death were 34.55% (19/55), 29.09% (16/55) and 10.90% (6/55), respectively, which were higher than those of grade Ⅰ ~ Ⅱ, the difference was statistically significant (P < 0.05). Conclusion The cardiac function status of pregnant women with heart disease is closely related to the outcome of maternal and perinatal pregnancy. The lower the cardiac function of pregnant women, the higher the incidence of preterm birth, the increase of complications of pregnant women and neonates, and the poor prognosis of neonates. Care and treatment should be strengthened to reduce the complications of pregnant women and newborns and improve the survival rate.