摘要
目的探讨不同的外科手术决策在妊娠期机械瓣膜失功能患者中的治疗效果。方法纳入我院2007~2017年诊断为妊娠期机械瓣功能障碍患者11例,平均年龄(27.5±3.7)岁,从孕周、心功能状态和进展速度,以及机械瓣膜梗阻程度,讨论不同治疗方案的结果。结果全组患者无死亡病例。3例患者因术中并发子宫大出血行子宫次全切术,其余8例患者手术顺利。妊娠<28周5例,其中1例胎儿抵院前发生胎死宫内,2例术后早期娩出死婴,2例妊娠至足月顺利分娩;妊娠>28周6例,均行剖宫产,其中1例胎儿死于颅内出血,存活5例。结论在妊娠期发生机械瓣失功能的患者,根据孕周、心功能状态及进展速度以及机械瓣膜梗阻程度,制定不同治疗方案,可提高孕产妇及胎儿存活率。
Objective To explore the therapeutic effects of different surgical strategies on women with mechanical valve dysfunction during pregnancy.Methods A total of 11 patients with mechanical valve dysfunction during pregnancy who underwent surgeries in our hospital from 2007 to 2017 were retrospectively included.The average age was 27.5±3.7 years.The prognosis of patients was analyzed according to the gestational weeks,cardiac function and the severity of mechanical valve dysfunction.Results No death occurred.Three of them suffered subtotal hysterectomy during the surgery because of uncontrolled bleeding,and the others recovered without complications.Among the 5 patients with pregnancies<28 weeks,1 patient was found intrauterine death before hospital admission,2 suffered fetal loss 5 days after the cardiac surgery,and the other 2 patients continued their gestations until deliveries.Among the other 6 patients with pregnancies>28 weeks,1 fetus died because of intracranial hemorrhage,and the other 5 survived without embryopathy or foetopathy.Conclusion Gestation week,cardiac function and severity of mechanical valve dysfunction may be taken into account when making a treatment regimen for women with dysfunctional valve prostheses during pregnancy.
作者
陈涌斌
卢聪
黄劲松
刘菁
郭惠明
庄建
黄焕雷
陈寄梅
CHEN Yongbin;LU Cong;HUANG Jingsong;LIU Jing;GUO Huiming;ZHUANG Jian;HUANG Huanlei;CHEN Jimei(Guangdong Provincial Cardiovascular Institute,Guangzhou,510080,P.R.China;Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou,510080,P.R.China)
出处
《中国胸心血管外科临床杂志》
CSCD
北大核心
2021年第8期940-944,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基金
国家重点研发计划(2018YFC1002600)
广东省登峰计划项目(DFJH201802,DFJH2019)
广东省科技计划项目(2019B020230003)。
关键词
机械瓣
妊娠
瓣膜失功能
剖宫产
Mechanical valve
gestation
valve dysfunction
cesarean section
