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目的探讨不同心脏病类型和心功能状态对妊娠合并心脏病患者母儿预后的影响。方法选择某院妇产科收治的妊娠合并心脏病患者86例,比较不同心脏病类型和心功能状态孕妇的终止分娩方式、终止妊娠孕周、孕妇心力衰竭发生例数、新生儿出生体重、1min Apgar评分及围产儿的早产和死亡情况。结果心律失常组较其他类型心脏病患者心力衰竭发生例数少,终止妊娠孕周时间长,剖宫产率、早产儿发生率和围生儿死亡率低,新生儿出生体重和新生儿Ap-gar评分高,差异均有统计学意义(P﹤0.05)。随孕妇心功能的级数增加,其心力衰竭发生例数、剖宫产率、围生儿死亡率和早产儿发生率均明显增加,终止妊娠孕周时间明显缩短,新生儿出生体重和新生儿Apgar评分明显下降,各组两两比较差异有统计学意义(P﹤O.05)。结论妊娠合并心脏病患者的心脏病类型和功能状态与其孕产妇及围产儿预后密切相关,早期诊断和评估心脏病类型和心功能状态是改善妊娠合并心脏病母儿预后的基本措施。
Objective To investigate the effects of different types of heart disease and cardiac function on the prognosis of pregnant women with pregnancy complicated with heart disease. Methods 86 cases of pregnancy complicated with heart disease admitted to obstetrics and gynecology department of a hospital were enrolled in this study. The mode of termination of delivery of pregnant women with different types of heart disease and cardiac function status, the gestational weeks of termination of pregnancy, the incidence of heart failure in pregnant women, the birth weight of newborns, Apgar score and perinatal premature delivery and death. Results Compared with other types of heart disease, arrhythmia group had fewer heart failure patients, longer gestational weeks, cesarean section rate, preterm birth rate and perinatal mortality rate. Neonatal birth weight and neonatal Ap- gar score was high, the difference was statistically significant (P <0.05). The number of heart failure cases, cesarean section rate, perinatal mortality rate and the incidence of preterm birth were significantly increased with the increase of heart function in pregnant women. The gestational weeks of termination of pregnancy were significantly shortened, the birth weight and neonatal Apgar score decreased significantly in each group compared with each other was statistically significant (P <0.05). Conclusions The type and functional status of heart disease in pregnancy complicated with heart disease are closely related to the prognosis of pregnant women and perinatal patients. Early diagnosis and assessment of heart disease type and cardiac function status are the basic measures to improve the prognosis of pregnant women with heart disease complicated by pregnancy.