妊娠合并肺动脉高压患者的妊娠结局及临床治疗分析

Pregnancy outcomes and clinical treatment of patients with pregnancy associated with pulmonary hypertension

目的探讨妊娠合并肺动脉高压患者的妊娠结局以及临床治疗方案。方法对2008年1月至2014年12月在第四军医大学西京医院治疗的132例妊娠合并肺动脉高压孕妇的诊治进行回顾性总结，分析轻度、中度以及重度肺动脉高压患者的心脏状态、妊娠结局以及临床治疗方案。结果轻度组足月分娩率最高，为79．10％；重度组最低，为13．79％。3组足月分娩率、早产率、医源性流产率、孕妇死亡率、小于胎龄儿生产率、新生儿窒息率以及新生儿死亡率比较均有显著性差异（x^2值分别为7．62、4．24、7．62、4．24、5．77、4．62、4．24，均P〈0．05）。结论肺动脉高压程度越严重，其妊娠结局越差。早期发现，及时治疗，慎重选择治疗方案，能降低母婴的患病率和死亡率，获得较好的妊娠结局。

Objective To investigate the pregnancy outcomes and clinical treatment plan of patients with pregnancy associated with pulmonary hypertension. Methods Retrospective summary was made on the diagnosis and clinical treatment of 132 cases of pregnancy associated with pulmonary hypertension from January 2008 to December 2014 in Xijing Hospital of Fourth Military Medical University. Cardiac status, pregnancy outcomes and clinical treatment were analyzed among mild group, moderate group and severe group. Results The term delivery rate was highest （79. 10% ） in mild group and lowest in severe group （ 13.79% ）. Full-term delivery rate, premature delivery rate, iatrogenic abortion rate, maternal mortality, rate of small for gestational age, neonatal asphyxia rate and neonatal mortality rate were significantly different among three groups （X2 value was 7.62, 4.24, 7.62, 4.24, 5.77, 4.62 and 4.24, respectively, all P 〈 0.05）. Conclusion The more severe the pulmonary hypertension is, the worse the pregnancy outcomes will be. Early detection, timely treatment and careful choice of treatment can reduce maternal and fetal prevalence and mortality rate and thus pregnancy outcomes are better.