心功能状态对妊娠并发心脏病产妇及新生儿预后影响

THE AFFECT OF CARDIAC FUNCTION ON THE PROGNOSIS OF LYING-IN WOMEN COMPLICATED WITH HEART DISEASE AND THEIR NEWBORNS

目的探讨心功能状态对妊娠并发心脏病产妇及新生儿预后的影响。方法对231例妊娠并发心脏病产妇的临床资料进行分析，分析心功能与心脏病患病率的关系、心功能与产科高危因素之间的相关性、不同心功能状态产妇的妊娠结局。结果心功能Ⅰ～Ⅱ级产妇孕次明显少于Ⅲ～Ⅳ级者，孕周大于Ⅲ～Ⅳ级者，差异有显著性（t=9．059、7．514，P〈0．05）。随着心功能级数的增高，新生儿Apgar评分明显降低（t=17．815，P〈0．05），早产率和围生儿病死率显著增加（x^2=0.798、22．223，P〈0．05），产妇心力衰竭发生率、剖宫产率明显增加（x^2=47．874、33．956，P〈0．05）。结论心功能状态与并发心脏病产妇及新生儿预后密切相关，提前诊断和预防，积极改善心功能是改善预后的主要措施。

Objective To investigate the affect of cardiac function on prognosis of lying-in women complicated with heart disease and their neonates. Methods Clinical data of 231 lying-in women complicated with heart disease were reviewed to analyze the association of cardiac function with the incidence of heart disease. correlation between cardiac function and obstetric high risk factors. and the outcomes of the women with different conditions of cardiac function. Results The gravidity of pregnant women with I - II cardiac function was obviously less and the gestational weeks were more than those with III- IV cardiac function. the differences were significant （t=9.0S9.7.S14;P〈0.OS）. Along with the increase of degree of cardiac function. the Apgar score of newborns notably lowered （t = 17. 81S. P 〈 0. aS）. the premature birth rate and perineonate mortality increased （x^2 = 60. 798. 22.223;P〈0.05）. the incidence of heart failure in lying-in women and cesarean section rate increased （x^2 =47.874.33.9S6;P〈 0.05）. Conclusion Cardiac function is closely associated with the prognosis of lying-in women complicated with heart disease and their newborn infants. making diagnosis and prevention in advance. and improving the cardiac function are the main measures to improve their outcomes.