[1]曹雪芹,胡文媛,李 娟,等.妊娠合并肺动脉高压严重程度对围生期结局的影响[J].医学信息,2019,32(16):58-61.[doi:10.3969/j.issn.1006-1959.2019.16.018]
　CAO Xue-qin,HU Wen-yuan,LI Juan,et al.Effect of Severity of Pregnancy with Pulmonary Hypertension on Perinatal Outcome[J].Journal of Medical Information,2019,32(16):58-61.[doi:10.3969/j.issn.1006-1959.2019.16.018]
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妊娠合并肺动脉高压严重程度对围生期结局的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年16期
页码:
58-61
栏目:
论著
出版日期:
2019-08-15

文章信息/Info

Title:
Effect of Severity of Pregnancy with Pulmonary Hypertension on Perinatal Outcome
文章编号:
1006-1959（2019）16-0058-04
作者:
曹雪芹1; 胡文媛2; 李 娟3; 林星光4; 龚 洵4; 曾万江4; 邓东锐4; 陈素华4; 冯 玲4; 余 楠4
1.华中科技大学同济医学院附属同济医院麻醉科，湖北 武汉 430030； 2.泰康同济<武汉>医院妇产科，湖北 武汉 430030； 3.昆明安琪儿妇产医院妇产科，云南 昆明 650000； 4.华中科技大学同济医学院附属同济医院妇产科，湖北 武汉 430030
Author(s):
CAO Xue-qin1; HU Wen-yuan2; LI Juan3; LIN Xing-guang4; GONG Xun4; ZENG Wan-jiang4; DENG Dong-rui4; CHEN Su-hua4;  FENG Lin4; YU Nan4
1.Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology, Wuhan 430030,Hubei,China; 2.Department of Obstetrics and Gynecology,Taikang Tongji (Wuhan) Hospital,Wuhan 430030,Hubei, China; 3.Departmen
关键词:
妊娠; 肺动脉高压; 围产结局
Keywords:
Key words：Pregnancy; Pulmonary arterial hypertension; Perinatal outcome
分类号:
R714.252
DOI:
10.3969/j.issn.1006-1959.2019.16.018
文献标志码:
A
摘要:
目的 探讨妊娠合并肺动脉高压（PAH）患者的临床情况、处理方法及母儿结局。方法 回顾性分析2016年1月~2018年12月在华中科技大学同济医学院附属同济医院收治的26例妊娠合并肺动脉高压患者的临床资料，根据肺动脉收缩压分为轻中度PAH患者及重度PAH患者，比较不同程度PAH患者的病因、心功能分级、终止妊娠孕周、方式及母儿结局。结果 重度PAH患者心功能Ⅲ~Ⅳ级者占66.67%，高于轻中度PAH患者的42.86%，但差异无统计学意义（P＞0.05）；重度PAH患者终止妊娠孕周为（28.98±12.01）周，早于轻中度PAH患者的（36.79±3.00）周，差异有统计学意义（P＜0.05）；重度PAH患者全麻率高于轻中度PAH患者（66.67% vs 7.14%），差异有统计学意义（P＜0.05）；重度PAH患者术中氧饱和度和输液量低于轻中度PAH患者、新生儿出生体重轻及小于胎龄儿发生率高，差异有统计学意义（P＜0.05）；重度PAH患者死亡率、新生儿窒息率高于轻中度PAH患者，但差异无统计学意义（P＞0.05），重度PAH孕妇的新生儿平均体重、小于胎龄儿发生率高于轻中度PAH孕妇，差异有统计学意义（P＜0.05）。结论 妊娠合并PAH患者肺动脉压力越高，围生结局越差，重度PAH患者妊娠可危及母婴健康和生命，不宜妊娠，可妊娠的轻中度患者应在多学科专家的严密监护下妊娠，并选择恰当方式适时终止妊娠，以改善母儿结局。
Abstract:
Abstract：Objective To investigate the clinical situation, treatment and maternal and child outcomes of patients with pregnancy complicated with pulmonary hypertension (PAH). Methods Retrospective analysis of 26 patients with pregnancy-induced pulmonary hypertension admitted to Tongji Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2016 to December 2018. According to pulmonary systolic pressure, patients with mild to moderate PAH and patients with severe PAH were retrospectively analyzed. To compare the etiology, cardiac function classification, termination of pregnancy, gestational age, and maternal and child outcomes of patients with different degrees of PAH.Results Patients with severe PAH with cardiac function III~IV accounted for 66.67%, which was higher than 42.86% for patients with mild to moderate PAH, but the difference was not statistically significant (P>0.05). The severe gestational week of severe PAH patients was (28.98±12.01)week, earlier than mild to moderate PAH patients (36.79 ± 3.00) weeks, the difference was statistically significant (P<0.05); severe PAH patients with general anesthesia rate was higher than mild to moderate PAH patients (66.67% vs 7.14%), the difference statistically significant (P<0.05); patients with severe PAH had lower intraoperative oxygen saturation and infusion than those with mild to moderate PAH, neonatal birth weight and small gestational age,the difference was statistically significant (P<0.05). The mortality and neonatal asphyxia rate of severe PAH patients were higher than those of mild and moderate PAH patients, but there was no significant difference (P>0.05). The average neonatal weight and small for gestational age were higher than those of mild and moderate PAH pregnant women, the difference was statistically significant (P<0.05).Conclusion The higher the pulmonary artery pressure in patients with pregnancy and PAH, the worse the perinatal outcome. The pregnancy of severe PAH can endanger the health and life of the mother and the baby. It is not suitable for pregnancy. The mild to moderate pregnancy can be pregnant under the strict supervision of multidisciplinary experts. Choose the right way to terminate the pregnancy at the right time for improving the maternal and child outcomes.

参考文献/References:

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更新日期/Last Update: 2019-08-15