分析妊娠合并风湿性心脏病的临床治疗

Retrospective Analysis of Treatments of Pregnant Women Complicated with Rheumatic Heart Diseases

目的探讨妊娠合并风湿性心脏病的有效治疗手段。方法收集首都医科大学附属北京安贞医院妇产科就诊于2002年1月至2009年1月期间的妊娠合并风湿性心脏病的25例患者的临床资料,对其进行回顾性分析。根据心脏病病种的治疗方式、心功能分级、产科检查情况进行分组分析。结果妊娠合并风湿性心脏病的发病率为0.49%。内科药物治疗14例,新生儿死亡1例。心脏手术治疗11例,其中孕前行瓣膜置换术5例,孕期行经皮二尖瓣球囊扩张术6例。结论妊娠合并风湿性心脏病严重危害母儿健康。心脏手术有效治疗妊娠合并风湿性心脏病。对比孕前行瓣膜置换术、孕期行经皮二尖瓣球囊扩张术对母儿预后的改善差异无统计学意义。

Objective To investigate the effects of different clinical therapies of pregnant women complicated with rheumatic heart diseases. Methods Clinical data of pregnant women complicated with rheumatic heart diseases collected from Beijing Anzhen Hospital from January 2002 to January 2009,were analyzed retrospectively. Results The prevalence of pregnancy complicated with rheumatic heart diseases was 3.91%. One neonatal death occurred in 14 cases who received drug treatment. Of 11 cases treated with heart surgery,5 cases received valve replacement surgery during progestation,6 cases received percutaneous balloon mitral valvuloplasty during gestational period. Conclusion The pregnancy complicated with rheumatic heart diseases does seriously harm the maternal-fetal health. The heart surgery was effective in treatment of pregnancy complicated with rheumatic heart diseases. Valve replacement surgery during progestation and percutaneous balloon mitral valvuloplasty during gestational period did not show significant difference in improving mother-fetal prognosis.