妊娠合并重型肝炎医源性心力衰竭18例分析

A study of 18 pregnancy women with heart failure of iatrogenic origin in hepatitis gravis

目的探讨妊娠合并重型肝炎出现心力衰竭的特点、原因和预防。方法回顾分析18例出现心力衰竭的妊娠合并重型肝炎病例，观察其临床表现、诊治过程，就24h出入量、感染、贫血、水电解质酸碱平衡与无心衰组进行比较，统计方法采用卡方检验和t检验。结果妊娠合并重型肝炎心衰发生率45％（18／40）；所有患者入量均明显多于出量，与无心衰组对比差异有统计学意义，感染以及血红蛋白、血钠、血钾、血钙、血镁、碳酸氢根方面差异无统计学意义；所有患者经常规强心、利尿、扩血管处理效果欠佳，心力衰竭难以纠正。结论妊娠合并重型肝炎易发生心力衰竭，与出入量不平衡有关，这种心力衰竭常规处理效果欠佳，严格控制补液量和速度有利于减少心力衰竭的发生。

Objective To explore the characteristics,causes and prevention of heart failure in hepatitis gravis during pregnancy. Methods 18 pregnancy women with heart failure in hepatitis gravis were looked back to, the clinical manifestation, the course of diagnosis and treament were observed. The total input and output liquid in 24 hours, infection, anemia and disorders of water, electrolyte and acld-base metabolism were compared between the heart failure group and non-heart failure group using Chi-sqare test and test. Results The incidence of heart failure is 45% （18/40） , the input amounts of all sufferers were much more than the output amounts, there was significant difference compared to non-heart failure group, yet there was no significant difference in infection, hemoglobin, serum natrium, serum potassium, serum calcium, serum magnesium and bicarbonate,all sufferers had poor responses to the routine therapy such heart-Strengthening,diuresis and extension blood vessel,the heart failure was hard to controlled. Conclusion Heart failure is prone to take place in hepatitis gravis during pregnancy,which is related to the unbalance of the input and output amount. The kind of heart failure has poor responses to routine therapy. Strict control over the amount and speed of transfusion will help to prevent it.