妊娠合并心脏病并发心力衰竭的危险因素分析  

First aid treatment and risk factors analysis of heart failure in pregnant women with heart disease

作　　者：任艳芳[1] 姜永杰[1] 张秀玲[1] 姜姗 

机构地区：[1]河南省新乡医学院第一附属医院产科,453100

出　　处：《中国妇产科临床杂志》2017年第5期413-415,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨合并心脏病的孕产妇发生心力衰竭的危险因素。方法回顾分析于河南省新乡医学院第一附属医院接受治疗的344例合并心脏病的孕产妇的临床资料,发生心力衰竭的61例患者作为观察组,同期未发生心力衰竭的258例患者作为对照组。给予发生心力衰竭的孕产妇急救治疗,并分别采用单因素、多因素Logistic回归法分析合并心脏病孕产妇并发心力衰竭的危险因素。结果基础心率>100次/min、先天性心脏病、围生期心肌病、风湿性心脏病、PAP>50 mm Hg、年龄≥35岁、孕前发生心脏事件、早孕期心功能分级≥Ⅱ级是心脏病孕产妇发生心力衰竭的独立危险因素(P<0.05),而孕前咨询和产前检查≥6次是其保护性因素(P<0.05)。结论合并心脏病孕产妇并发心力衰竭受多种因素影响,在临床中应对危险因素干预或规避,并帮助患者积极实现保护性因素,从而降低心力衰竭的发生率。Objective To understand the first aid treatment for heart failure in hospitalized pregnant women with heart disease, and explore the risk factors of heart failure. Methods A retrospective analysis was made from 344 cases pregnant women with heart disease in our hospital from May 2011 to February 2016.61 heart failure patients were selected from all cases as observation group. 258 pregnant women with heart diseases during the same period were selected as control group. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of heart failure in pregnant women with heart diseases. Results Logistic regression analysis showed baseline heart rate ~ 100 bpm, congenital heart disease, peripartum cardiomyopathy, rheumatic heart disease, pulmonary artery pressure ~ 50 mm Hg, age ~〉 35 years, cardiac events occurred before pregnancy, and the baseline parameters of NYHA ]I were the independent risk factors for heart failure （P^0.05）. Prenatal counseling and antenatal examination were protective factors （P〈0.05）. Conclusions There are multiple influencing factors for the heart failure in pregnant women with heart disease. It is necessary to take intervention measures to the risk factors and protective factors as soon as possible, to reduce the development of heart failure.

关 键 词：妊娠合并心脏病 心力衰竭 急救 危险因素 

分 类 号：R714.252[医药卫生—妇产科学]