妊娠合并心律失常275例临床分析  

Outcome of pregnancies complicated with arrhythmias:a review of 275 patients

作　　者：王妍[1] 张龑[1] 赵扬玉[1] 杨孜[1] 叶蓉华[1] 李诗兰[1] 魏媛[1] 王永清[1] 江元慧[1] 

机构地区：[1]北京大学第三医院妇产科,北京100091

出　　处：《中国生育健康杂志》2009年第5期273-277,共5页Chinese Journal of Reproductive Health

摘　　要：目的探讨妊娠合并心律失常对妊娠结局的影响。方法对北京大学第三医院1993年1月～2009年6月间妊娠合并心律失常275例住院分娩患者的临床资料进行回顾性分析。结果妊娠合并心律失常以窦性心动过速最为常见,占48.7%(134/275),其次为房性或室性期前收缩和预激综合征,分别占29.5%(81/275)和13.8%(38/275);妊娠合并心律失常中84.7%(233/275)为无器质性心脏病,心功能为Ⅰ～Ⅱ级,15.3%(42/275)为器质性心脏病心律失常患者;无器质性心律失常患者妊娠结局良好,无孕产妇死亡,器质性心脏病且心功能Ⅲ～Ⅳ级心律失常患者的平均分娩孕周明显缩短(P<0.05),医源性早产、围生儿死亡和孕产妇死亡分别占32.3%(11/34)、17.6%(6/34)和5.9%(2/34)。结论妊娠合并心律失常患者的妊娠结局与是否存在器质性心脏病及心功能状态密切相关;妊娠合并无器质性心律失常患者心功能较好,通过规范管理、合理治疗可以获得良好的妊娠结局;器质性心脏病心律失常心功能Ⅲ～Ⅳ级孕产妇因心脏原因致医源性早产、围生儿死亡、孕产妇死亡均明显增加。Objective To investigate the influence of cardiac arrhythmias during pregnancy on mothers and their newborns. Methods 275 eases of pregnancies complicated with cardiac arrhythmias were reviewed. Results The most common cardiac arrhythmias during pregnancy were sinus tachyeardia （48.7%）. This was followed by premature atrial contractions （PACs） or premature ventrieular contractions （PVCs） （29. 5 % ）, and Wollf-Parkinson-White syndrome （ 13. 8 % ）. 233 cases with arrhythmias were normal cardiac structure with the NYHA grading Ⅰ-Ⅱ. The remaining 42 cases were abnormal cardiac structure. The average gestatianal weeks of the patients with normal structure arrhythmias were significantly higher than that of the patients with abnormal cardiac structure （ P 〈 0. 05）. Perinatal mortality and medical premature delivery were more common in patients who were cardiac arrhythmias with abnormal cardiac structure than in patients with normal structure cardiac arrhythmias. Conclusion The outcome of pregnancies complicated with arrhythmias with normal cardiac structure are optimal in most patients with standard medical therapy.

关 键 词：妊娠 心律失常 心功能 

分 类 号：R541.7[医药卫生—心血管疾病] R714.21[医药卫生—内科学]