标题：妊娠合并风湿性心脏病25 例临床分析

      作者：李秀彦，茹美艳
    （海南省人民医院产科，海南海口570311）

      卷次： 2012年23卷6期

      【摘要】目的探讨风湿性心脏病患者心脏手术和未心脏手术及不同心功能状态对分娩结局的影响。
方法对2003 年1 月至2010 年12 月收治的25 例风湿性心脏病孕妇妊娠结局进行回顾分析。1）根据孕期是否进
行心脏手术分为心脏手术组10 例（A组），未手术组15 例（B组），对两组围产儿进行分析。2）根据患者的心功能
状态分为Ⅰ级组7 例，Ⅱ级组9 例，Ⅲ级组7 例，Ⅳ级组2 例。观察各组的围产儿结局。结果未心脏手术组与心
脏手术组比较早产、FGR差异有统计学意义。心功能Ⅰ级与Ⅱ级组足月分娩及新生儿出生体重比较，差异无统
计学意义。结论风湿性心脏病手术后可明显改善妊娠结局，心功能Ⅲ~Ⅳ级患者围产儿结局不良，合并重度肺
动脉高压及心房纤颤容易诱发心力衰竭，危及母婴生命，不宜妊娠。

      【关键词】风湿性心脏病；心脏瓣膜置换术；心功能；围产儿结局

      【中图分类号】R714.252 【文献标识码】A 【文章编号】1003—6350（2012）06—057—03
r>Clinical study on 25 cases of pregnancy complicated with rheumatic heart disease.
LI Xiu-yan, RU Mei-yan.
Department of Obstetrics, The People’s Hospital of Hainan Province, Haikou 570311, Hainan, CHINA
【Abstract】Objective To investigate the outcome of pregnancy in pregnant women with rheumatic heart disease
who had received a operation or without operation. Methods The clinical data of 25 pregnant women with heart
diseases from Jan. 2002 to Dec. 2009 were analyzed retrospectively. (1) The 25 patients were divided into Group A (received
heart surgery, n=10) and Group B (not received heart surgery, n=15). The outcome of pregnancy was compared
between the two groups. (2) The 25 patients were divided into four groups according heart function: GradeⅠ (n=7),
Grade Ⅱ (n=9), Grade Ⅲ (n=7), Grade Ⅳ (n=2). The outcome of pregnancy was compared between the four groups.
Results The premature birth rate and fetal growth restriction (FGR) was significant higher in group A than group B.
The rate of pregnancy at term and weight of neonate showed no statistically significant difference between GradeⅠ
and Grade Ⅱ, but showed statistically significant difference between Grade Ⅰ ~ Ⅱ and Grade Ⅲ ~ Ⅳ. Conclusion
Surgical interventions can improve the cardiac function, reduce the pregnancy complications and improve the pregnancy
outcomes in pregnant women with rheumatic heart disease. The patient whose heart function of grade Ⅲ~Ⅳ with