常见胎儿心律失常的临床意义探讨  

The clinical significance of common fetal arrhythmia.

作　　者：施展[1] 刘明颖[1] 李辉[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004

出　　处：《中国优生与遗传杂志》2009年第9期79-80,52,共3页Chinese Journal of Birth Health & Heredity

基　　金：国家十一五科技支撑计划资助;项目号:2006BAI05A04;项目主持单位:北京协和医院;辽宁省科技攻关项目资助课题;项目号2005225008

摘　　要：目的对临床常见的心律失常胎儿进行追踪随访,探讨胎儿心律失常的临床意义及其预后。方法选择2004年至2008年间在中国医科大学附属盛京医院就诊的胎儿心律失常患者436例,进行胎儿心脏结构检查,判断胎儿心律失常类型并给予正确的临床处理。结果1.23例胎儿选择终止妊娠,其中心脏结构异常6例(1.4%),4例(0.92%)出现胎儿心衰表现,另13例无心脏异常及心衰表现,仅因患者及家属不愿承担风险,而选择终止妊娠;2.17例给予宫内药物治疗,其中治疗有效为6例(35.3%),2例(11.8%)出生后好转,6例(35.3%)终止妊娠,3例(17.6%)出现心衰后死亡;3.随访继续妊娠胎儿除1例于新生儿期死亡,其余新生儿预后良好,心律失常于出生前或出生后消失。结论绝大多数胎儿心律失常,多不伴有心脏血管结构异常,一般无需特殊处理即可消失,临床预后良好。严重的心律失常可导致胎儿水肿、心衰甚至危害胎儿生命,应积极进行治疗或选择终止妊娠。Objective ： Follow up clinical common fetal arrhythmia, and discuss clinical significance of fetal arrhythmia and fetal prognosis. Methods ： From 2004 to 2008, 436 pregnant women came to Shenyang Shengjing Hospital were diagnosed fetal arrhythmia. A long - time following - up was given to these pregnant women. The results of following - up were analyzed to evaluate clinical significance of fetal arrhythmia and fetal prognosis. Results： 1. 23 cases were given induced abortion, 6 （1.4%） abortion cases because of congenital heart diease, 4 （0. 92% ） abortion cases because of heart failure, 13 abortion cases just because of parents＇anxiety; 2. 17 fetuses receive intrauterine drug therapy, after treatment 6 fetuses get better, 2 fetuses get better after birth, 6 cases receive abortion, 3 fetuses die because of heart failure; 3. other fetuses have a good prognosis except 1 dies. Conclusion： most fetal arrhythmia with normal heart structure cases have a good prognosis, arrhythmias will disappear without medical treatment, severe arrhythmia will induce fetal edema, heart failure even threaten fetal life, docters should treat in time or give terminations of pregnancy.

关 键 词：胎儿 心律失常 

分 类 号：R714.58[医药卫生—妇产科学]