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1 妊娠合并心脏病的血液动力学改变 1.1 妊娠期 (1)血容量增加:是妊娠期最主要的血液动力学改变。非孕期时血容量约为3250ml,孕6周开始血容量逐渐增加,至孕32～34孕周达高峰,平均增加40％～50％。血容量增加与胎儿大小成正相关。因此,经产妇或多胎妊娠时血容量增加更为明显。由于血浆增加较红细胞增加为著,因而孕期常出现“生理性贫血”。 (2)心排出量增加:心排出量取决于心率及心搏出量(每搏心排出量)。孕期心率每分钟约增加10～15次。心排出量增加至孕13～23孕周达高峰,平均增加30％,以侧卧最为明显。 (3)血压的变化:动脉压,中心静脉压及肺毛细血
1 pregnancy hemodynamic changes with heart disease 1.1 gestational age (1) increased blood volume: is the most important during pregnancy hemodynamic changes. Non-pregnancy blood volume is about 3250ml, 6 weeks pregnant blood volume gradually increased, reaching 32 to 34 gestational weeks pregnant peak, an average increase of 40% to 50%. The increase in blood volume is positively related to the size of the fetus. Therefore, the increase in blood volume after the maternal or multiple gestational pregnancy more pronounced. Due to plasma increased erythrocyte increase, and therefore often appear during pregnancy, “physiological anemia.” (2) increased cardiac output: cardiac output depends on the heart rate and cardiac output (stroke cardiac output). Pregnancy heart rate increased about 10 to 15 times per minute. Cardiac output increased to 13 to 23 gestational weeks reached the peak, with an average increase of 30% to the most obvious side lying. (3) changes in blood pressure: arterial pressure, central venous pressure and pulmonary capillary