妊娠合并心律失常100例临床分析

Clincal analysis of 100 cases of pregnancy complicated with cardiac arrhythmias

目的探讨妊娠合并心律失常的临床诊治及其对妊娠结局的影响。方法选择我院2006—2016年100例妊娠合并心律失常住院分娩产妇为研究对象,对其临床资料进行统计分析。结果在所有100例妊娠合并心律失常产妇中,占比例最高的是窦性心动过速,为47.0%(47/100);无器质性心脏病者占82.0%(82/100),心功能均为Ⅰ~Ⅱ级;器质性心脏病者占18.0%(18/100),其中4例心功能为Ⅰ~Ⅱ级,另外14例为心功能Ⅲ~Ⅳ级,后者分娩孕周短于心功能Ⅰ~Ⅱ级者,差异有统计学意义(P<0.05);82例无器质性心脏病者中无孕产妇、围生儿死亡,18例器质性心脏病者中孕产妇死亡1例、围生儿死亡3例。结论妊娠合并心律失常产妇若不存在器质性心脏病则通过规范化的治疗获得较好的妊娠结局;妊娠合并心律失常若存在器质性心脏病则早产率较高,且易导致不良妊娠结局。

Objective To explore the clinical diagnosis and treatment of pregnancy complicated with cardiac arrhythmias and its influence to the pregnancy outcomes. Methods One hundred cases of pregnancy complicated with cardiac arrhythmias from 2006 to 2016 were selected, the clinical data of all the patients were statistically analyzed. Results The most common cardiac arrhythmias during pregnancy were sinus tachycardia, with 47.0% （47/100）, 82.0%（82/100） cases with arrhythmias were normal cardiac structure with the NYHA grading I-II; 18 cases were abnormal cardiac structure, with 4 cases of the NYHA grading I-II and 14 cases of the NYHA grading I^-IV. The average gestational weeks of the patients with normal structure arrhythmias were significantly higher than that of the patients with abnormal cardiac structure （P〈 0.05）; there was no maternal death and fetal mortality in 82 cases of normal cardiac structure, the maternal mortality was 1 case and fetal mortality was 3 cases in patients with normal structure arrhythmias. Conclusion If there is no organic heart disease, the patients of pregnancy complicated with cardiac arrhythmias can get better pregnancy results by standardized treatment, if there is organic heart disease in pregnancy complicated with arrhythmia, the premature birth rate is high, and it can easily lead to adverse pregnancy outcomes.