妊娠合并艾森曼格综合征危重患者术后重症监护室治疗分析

Postoperative treatment for pregnant patients with Eisenmenger syndrome in ICU

目的探讨妊娠合并艾森曼格综合征(Eisenmenger's syndrome,ES)危重患者术后重症监护室(ICU)的综合治疗方法。方法 2010年4～8月收治妊娠合并ES术后入ICU的3例危重患者,给予呼吸机辅助呼吸及强心、利尿、扩血管等对症治疗。结果 2例患者分别于术后1周内突然出现意识丧失、氧饱和度进行性降低而死亡,临床高度考虑为肺栓塞。另一例患者剖宫产术后入ICU,监护治疗4周平安出院。结论妊娠合并ES母儿的死亡风险极大,产后应入ICU监护治疗,雾化吸入伊洛前列素联合口服西地那非可有效降低肺动脉高压,从而减少右向左分流,降低患者病死率。

Objective To investigate the postoperative combined therapy for critical pregnant patients with Eisenmenger syndrome（ES） in intensive care unit（ICU）.Methods Three pregnant patients with ES were admitted into ICU from April 2010 to August 2010 and underwent assisted respiration and symptomatic treatments with cardiac,diuretic and vasodilator.Results Two cases died within 1 week due to loss of consciousness and gradual decrease of oxygen saturation,which was clinically suspected as pulmonary embolism.The third case was admitted in ICU after caesarean section for 4 weeks till being discharged.Conclusions Pregnant women with ES was associated with extremely poor maternal and fetal outcome,and must be sent to ICU after delivery.Iloprost Solution for Inhalation combined with Sildenafil can effectively lower pulmonary hypertension,reduce right-left shunt,and decrease the mortality of patients.