重度子痫前期并发心功能不全34例分析

Retrospective analysis of 34 cases with pre-eclampsia with cardiac insufficiency

目的探讨重度子痫前期并发心功能不全的诱因、早期诊断和预防。方法对绍兴市妇幼保健院2006年1月至2010年1月期间收治的34例重度子痫前期并发心功能不全(孕前无心脏疾病)的患者和同期未发生心功能不全的87例重度子痫前期患者的临床资料进行回顾性分析和比较。结果心功能不全组的收缩压、舒张压、心率均高于无心功能不全组(差异有显著性,P<0.05);心功能不全组患者水肿、贫血、低白蛋白血症的程度均重于无心功能不全组患者(差异有显著性P<0.05);产前出现心功能不全25例,产时心功能不全1例,产后心功能不全8例;心功能不全组围产儿死亡率、新生儿窒息发生率及小于胎龄儿和足月小样儿的比例高于无心功能不全组(差异有显著性P<0.05)。结论重度子痫前期并发妊娠高血压性心脏病心功能不全病情重,可危及母儿生命,应积极治疗原发病、去除诱因。水肿、贫血、低白蛋白血症、不合理扩容及输液过量过速是妊娠高血压性心脏病心功能不全的常见诱发因素。加强产前检查可便于早发现早治疗,重视产时及产后心衰的预警。

Objective：To investigate the associated factors and prevention of cardiac insufficiency in patients with pre-eclampsia.Methods：34 cases of patients with pre-eclampsia and cardiac insufficiency Ⅱ to Ⅳ（NYHA standard）（Group A） and 87 cases of patients with pre-eclampsia but without cardiac insufficiency（Group B） from January,2006 to January 2010 were analyzed retrospectively.Results：A group＇s blood pressure and heart rate are higher than B group（P0.05）.A group′s dropsy,anemia and the low albuminemia degree is more serious than B group（P0.05）.There were 25 cases of cardiac insufficiency occurred prepartum（73.53%）,1 cases during delivery（2.94%）,and 8 cases postpartum（23.53%）.A group′s perinatal mortality,the rate of newborn suffocates and small for gestational age to be higher than B group（P0.05）.Conclusion：Pre-eclampsia complicated with cardiac insufficiency is acute and severe disease and endanger survival of fetus and pregnant woman.The essential therapy is controlling congestive heart failure and termination of pregnancy.Cardiac insufficiency during delivery and postpartum deserve more care.