妊娠期非急诊体外循环心脏手术的单中心回顾性队列研究  

Non-emergency cardiac surgery with cardiopulmonary bypass during pregnancy:A retrospective cohort study in a single center

作　　者：谢慈燕 罗晓康 陈寄梅[1,2] 庄建 XIE Ciyan;LUO Xiaokang;CHEN Jimei;ZHUANG Jian(Department of Cardiac Surgery,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangdong Cardiovascular Institute,Guangzhou,510080,P.R.China;Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangzhou,510080,P.R.China)

机构地区：[1]广东省心血管病研究所广东省人民医院(广东省医学科学院)心外科,广州510080 [2]广东省华南结构性心脏病重点实验室,广州510080

出　　处：《中国胸心血管外科临床杂志》2022年第6期724-728,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划(2018YFC1002600);广东省科技计划项目(2019B020230003);广东省登峰计划项目(DFJH201802,DFJH2019)。

摘　　要：目的总结单中心近11年妊娠期心脏手术的临床经验。方法回顾性分析广东省人民医院2010—2020年妊娠合并心脏病行非急诊体外循环心脏手术26例患者的临床资料,平均年龄(28.6±4.9)岁。根据手术时孕周将患者分为两组:变化组(手术时孕周<21周)和稳定组(手术时孕周≥21周)。收集患者的住院资料及随访资料。结果手术时平均孕周为(23.4±4.2)周。11例为先天性心脏病,15例为心脏瓣膜病。平均术后重症监护治疗时间(2.5±2.4)d,平均总住院时间(22.5±9.5)d,共5例术后胎儿死亡。随访中患者无死亡。两组患者在术后结局方面差异无统计学意义。结论妊娠期心脏手术的患者数量在增加,死亡率低、预后情况良好,但术后胎儿流失率仍有待降低。妊娠生理性心肺改变建立前后行心脏手术不改变患者术后结局。Objective To summarize the clinical experience of cardiac surgery during pregnancy in a single center for the past 11 years.Methods The clinical data of 26 pregnant patients(mean age 28.6±4.9 years)complicated with heart diseases who underwent non-emergency cardiac surgery with cardiopulmonary bypass from 2010 to 2020 in Guangdong Provincial People's Hospital were retrospectively analyzed.Patients were divided into two groups according to the gestational age at the time of surgery:a change group(gestational age<21 weeks)and a stable group(gestational age≥21 weeks).The hospitalization data and follow-up data of the patients were collected.Results Mean gestational age at surgery was 23.4±4.2 weeks.Eleven patients had congenital heart diseases and fifteen had valvular heart diseases.Mean postoperative ICU stay was 2.5±2.4 d,and mean total hospital stay was 22.5±9.5 d.There were 5 postoperative fetal losses.There was no maternal death during follow-up.No statistical difference in the maternal postoperative outcomes between two groups.Conclusion The number of patients undergoing cardiac surgery during pregnancy is increasing.The maternal mortality rate is low and the prognosis is good,but the fetal loss remains concern.Cardiac surgery performed before or after the establishment of cardiopulmonary adjustment in pregnancy does not change the maternal postoperative outcomes.

关 键 词：妊娠 心脏手术 体外循环 孕周 宫内保留胎儿 

分 类 号：R714.252[医药卫生—妇产科学]