妊娠期体外循环下心脏手术临床处理策略  

Management of cardiac surgery with cardiopulmonary bypass in pregnancy

作　　者：宣煜龙[1] 潘俊[1] 周庆[1] 王强[1] 王东进[1] 

机构地区：[1]南京大学医学院附属南京鼓楼医院心胸外科,210008

出　　处：《中华胸心血管外科杂志》2016年第5期306-308,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：妊娠与非妊娠患者行体外循环下心脏手术，预后无明显差异，但术后胎儿生存率较低。孕妇和胎儿出现不良预后主要与体外循环密切相关。对孕妇实施体外循环下心脏手术时，术前使用药物调整患者心功能，围手术期监测胎儿生命体征，良好管理体外循环，争取在心脏手术前娩出胎儿，尽量选择在孕中期的3个月内行手术治疗，均可有效改善孕妇及胎儿预后。Cardiac surgery carried out on cardiopulmonary bypass（CPB） in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utcro-placental hypopeffusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-opcrative optimization of maternal cardiovascular status, use of pcrioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

关 键 词：体外循环 心脏手术 妊娠期 临床处理 胎儿预后 围手术期监测 不良预后 药物调整 

分 类 号：R714.252[医药卫生—妇产科学]