子痫前期术后心力衰竭1例个案分析及文献回顾

A case study of heart failure after cesarean section for preeclampsia and literature review

妊娠期高血压疾病是导致孕产妇和围产儿死亡的主要原因之一,且易导致心脑肝肾等严重并发症。子痫前期是妊娠期高血压病情的进展,给孕产妇及围产儿带来的损伤是临床无法预估的。本文介绍了一例38岁孕妇,入院诊断为子痫前期,剖宫产术后1小时突发胸闷憋气、端坐呼吸、血压升高、心率增快、血氧饱和度进行性下降,左室射血分数47%,伴胸腔积液等心力衰竭相关表现,给予降压、利尿、呼吸机辅助呼吸后症状逐渐好转。结果显示,子痫前期剖宫产术后并发心力衰竭需及时给予降压、利尿、辅助呼吸等治疗,降低心脏负荷,改善孕产妇预后。

Hypertension during pregnancy is one of the main causes of maternal and perinatal mortality, and it is easy to lead to serious complications in many organs such as heart, brain, liver and kidney. Preeclampsia is the progression of pregnancy hypertension, and the damage it brings to pregnant women and perinatal infants is clinically unpredictable. In this paper, the patient is a pregnant women of 38 years old, she was diagnosis of preeclampsia in the hospital at admission. One hour after cesarean section, heart failure related symptoms such as felt chest distress and suffocated, orthopnoea, the blood pressure rising, heart rate turn fast, progressive decrease in oxygen saturation, left ventricular ejection fraction reached 47%, and pleural effusion occurred to her. Fortunately, the symptoms getting better after treatment of depressurization, diuresis, and assisted breath of ventilator.Timely antihypertensive, diuresis, assisted breathing and other treatments given to patients suffere with preeclampsia complicated with heart failure after cesarean section could reduce cardiac load and improve the prognosis of pregnant and parturients.