妊娠高血压性心脏病终止妊娠临床分析.docVIP

妊娠高血压性心脏病终止妊娠临床分析 　　[摘要] 目的:研究妊娠高血压性心脏病终止妊娠的时机、方式及结局对孕妇及围生儿的影响。方法:对2008～2009年47例妊娠高血压性心脏病患者的临床资料进行回顾性分析。观察剖宫产与阴道分娩、孕周时间长短、心衰控制对孕妇及围生儿预后的差异。结果:剖宫产组新生儿窒息率明显低于阴道分娩组(P0.05),孕周长和孕周短低体重儿出生率差异有统计学意义(P0.05)。结论:对于妊娠期高血压性心脏病患者应积极控制心衰,采取合适的方式适时终止妊娠。 　　[关键词] 妊娠高血压性心脏病;终止妊娠;剖宫产;阴道分娩 　　[中图分类号] R541.3[文献标识码]A [文章编号]1673-7210(2010)05(c)-050-02 　　 　　Clinical analysis of hypertensive heart disease termination of pregnancy 　　LIN Yinmei, WEI Miaojiao 　　(The South District Family Planning Services of Dongguan City, Dongguan 523700, China) 　　[Abstract] Objective: To study the efects of pregnancy-induced hypertension heart disease termination of pregnancy timing, manner and outcome of pregnant women and perinatal effects. Methods: 47 cases of patients with pregnancy-induced hypertension heart disease from 2008 to 2009 were analyzed retrospectively. Gestational duration, heart failure and control pregnant women and perinatal prognosis were observed in the cesarean section group and vaginal delivery group. Results: The rate of neonatal asphyxia of the cesarean section group was lower than that of vaginal delivery group(P0.05), there was a significant difference in the children low birth weight of gestation length and short (P0.05). Conclusion: Pregnancy in patients with hypertensive heart disease should be actively controlled heart failure and take appropriate way of timely termination of pregnancy. 　　[Key words] Pregnancy-induced hypertension heart disease; Termination of pregnancy; Cesarean; Vaginal delivery 　　 　　妊娠高血压性心脏病,即妊娠期高血压疾病并发急性左心衰,以心肌损害为特征,是母婴最严重的并发症之一,多发生于妊娠20周以后。临床表现为高血压、水肿、蛋白尿,严重时出现抽搐、昏迷、心肾功能衰竭,甚至发生母婴死亡。病因机制十分复杂,其病因尚不十分清楚。终止妊娠是治疗妊娠期高血压疾病的最佳方法。因此,采取合适的终止妊娠的方式,适时地终止妊娠是值得关注的问题。本文对2008～2009年东莞市南城区计划生育服务所的就诊的妊娠期高血压疾病性心脏病患者的临床资料进行了回顾性分析,观察终止妊娠的时机、方式及结局对孕妇及围生儿的影响,现报道如下: 　　1 资料与方法 　　1.1 一般资料 　　本组中47例妊娠期高血压疾病性心脏病患者,均符合妊娠期高血压性心脏病的诊断标准,既往无高血压、肾病、心脏病或心力衰竭病史。孕妇年龄24～38岁,平均28.7岁;初产妇39例,经产妇8例,均为单胎;剖宫产36例,阴道分娩11例;孕周32～36周29例, 37～39周18例。 　　1.2 方法 　　首先降血压:首选酚妥拉明20～30 mg加入5%葡萄糖溶液