高龄孕妇妊娠晚期的常规心电图改变

Changes of Routine Electrocardiogram in Elderly Pregnant Women in the Third Trimester of Pregnancy

目的:探究高龄孕妇妊娠晚期的心电图特点,为临床提供指导.方法:选取2017年1月-2019年6月在本院行心电图检查的妊娠晚期孕妇190例.根据年龄进行分组,年龄≥35岁的95例孕妇作为高龄组,年龄<35岁的95例孕妇为适龄组.观察两组孕妇常规心电图检查结果,比较两组心电图异常孕妇妊娠情况及产前与产后心电图变化情况.结果:高龄组孕妇妊娠晚期异常心电图的发生率为63.16%,高于适龄组的22.11%,其中心律失常、窦性心律过速、ST-T改变、导联低电压的发生率均高于适龄组,差异均有统计学意义(P<0.05).在心电图异常的两组孕妇中,高龄组60例,适龄组21例,高龄组的妊娠丢失率、早产率、新生儿低体质量发生率均略高于适龄组,但两组比较,差异均无统计学意义(P>0.05).两组孕妇产后异常心电图检出率均低于产前,高龄组ST-T改变的检出率低于产前,差异均有统计学意义(P<0.05).结论:高龄孕妇多为经产妇,且妊娠晚期易出现心律失常、ST-T等异常心电图改变.临床上需关注高龄孕妇妊娠晚期心电图变化,保证母婴的安全.

Objective:To explore the characteristics of electrocardiogram of elderly pregnant women in the third trimester of pregnancy and provide guidance for clinical practice.Method:A total of 190 pregnant women in the third trimester who underwent electrocardiogram examination in our hospital from January 2017 to June 2019 were selected.They were grouped by age,95 pregnant women aged≥35 years old were regarded as the elderly group,95 pregnant women under the age of 35 were in the age-appropriate group.The results of routine electrocardiogram of pregnant women in the two groups were observed.The two groups of pregnant women with abnormal electrocardiogram and the changes of electrocardiogram before and after delivery were compared.Result:The incidence of abnormal electrocardiogram in the third trimester of pregnancy in the elderly group was 63.16%,higher than 22.11%in the age-appropriate group,and the incidence of arrhythmia,sinus tachycardia,ST-T change and lead low voltage were all higher than those in the age-appropriate group,with statistically significant differences(P<0.05).Among the two groups of pregnant women with abnormal electrocardiogram,there were 60 cases in the elderly group and 21 cases in the age-appropriate group.The pregnancy loss rate,preterm birth rate and neonatal low body mass rate of the elderly group were slightly higher than those of the age-appropriate group,but the differences between the two groups were not statistically significant(P>0.05).The detection rate of abnormal electrocardiogram in both groups were lower than those of before birth,the detection rate of ST-T change in the elderly group was lower than that in the prenatal group,the differences were statistically significant(P<0.05).Conclusion:Elderly pregnant women are mostly transparietal mothers,and abnormal electrocardiogram changes such as arrhythmia and ST-T are easy to occur in the third trimester.Clinical attention should be paid to the changes of electrocardiogram in the third trimester of pregnancy in elderly pregnant women to ensure the safety of mothers and infants.