产科医源性心衰18例临床分析

A clinical analysis on 18 obstetric patients with iatrogenic heart failure

目的探讨产科医源性心衰的原因和预防。方法回顾性分析2007至2011年在我院发生的医源性心衰18例临床资料，同期随机选取20例分娩无发生心衰的孕产妇作为对照组，寻找产科医源性心衰的发病原因及预防措施。结果妊娠期高血压疾病9例（50％），产后大出血8例（44．4％），妊娠合并贫血9例（50％），低蛋白血症12例（66．7％）；心衰发生的时间，产前2例，产时2例，产后14例。结论产科医源性心衰的主要病因是产科医务人员对孕产妇的病情评估不足够，静脉补液的量及速度控制不恰当，护理观察不够细致。

Objective To investigate the etiologies and prevention of iatrogenic heart failure in obstetric patients,Methods The clinical data on 18 ptients who had occurred iatrogenic heart failure duringthe period of 2007 to 2011 were retrospectively analyzed. 20 puerperas without heart failure were used as control. The pathogenesis of iatrogenic heart failure and and the relevant measures for prevention were determined. Results 9 of the 18 （50%） patients were due to pregnancy-induced hypertension, 8 （44.4%） due to postpartum hemorrhage, 9 （50%） due to anemia, and 12 （66.7%） due to hypoalbuminemia. 2 patients developed heart failure prenatally, 2 intrapartally, and 14 postpartally. Conelusions Underestimation of disease course by obstetric staff, inappropriate control of volume and speed of intravenous infusion, and careless observation by nurses are the major causes of iatrogenic heart failure in obstetric patients.