12例妊娠合并肺动脉高压患者的病因分析及重症监护治疗  

Etiological analysis and intensive care treatment of 12 patients with pulmonary hypertension in pregnancy

作　　者：朱睿瑶[1] 喻淑慧 高文蔚[1] 邹捍东[1] 詹丽英[1] ZHU Ruiyao;YU Shuhui;GAO Wenwei;ZOU Handong;ZHAN Liying(Dept.of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院重症医学科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第4期552-557,共6页Medical Journal of Wuhan University

基　　金：湖北省中央引导地方科技发展专项基金(编号:2020ZYYD004)。

摘　　要：目的:总结妊娠合并肺动脉高压(PH)的高危孕产妇的病例资料、管理经验、病因分析及重症监护治疗。方法:对武汉大学人民医院2019年1月至2021年12月收入的12例妊娠合并肺动脉高压患者进行回顾性分析,根据肺动脉收缩压分为轻度组(30~50 mmHg)、中度组(51~80 mmHg)和重度组(≥81 mmHg),比较各PH组患者病因种类、心功能级别及治疗效果评估。结果:(1)本研究纳入12例妊娠合并PH的患者中,7例为先天性心脏病相关肺动脉高压,主要表现为房间隔缺损(83.3%),其次为室间隔缺损(33.3%)、动脉导管未闭(16.7%)、法洛四联症(16.7%);另外5例为风湿性心脏病相关肺动脉高压,病理特征以二尖瓣狭窄为主;(2)早期给予降肺动脉压力治疗,可改善患者的预后。结论:妊娠合并PH患者给予降低肺动脉压力治疗可改善患者的结局。Objective:To study the etiological analysis and intensive care treatment of high-risk pregnant women with combined pulmonary hypertension(PH)in pregnancy.Methods:A retrospective analysis was performed on 12 patients with combined PH in pregnancy admitted to Renmin Hospital of Wuhan University from January 2019 to December 2021,and the patients were divided into mild group(30-50 mmHg),moderate group(51-80 mmHg),and severe group(≥81 mmHg)according to pulmonary artery systolic pressure.The the types in etiology,cardiac function level,and outcomes after treatment between different PH groups were compared.Results:(1)Among the 12 patients with PH combined with pregnancy included in this study,7 cases were congenital heart disease-associated pulmonary hypertension,mainly manifested by atrial septal defect(83.3%),followed by ventricular septal defect(33.3%),patent ductus arteriosus(16.7%),and tetralogy of Fallot(16.7%);the other 5 cases were rheumatic heart disease-associated pulmonary hypertension,with pathological features of mitral stenosis.The other 5 cases were rheumatic heart disease-related pulmonary hypertension,with mitral stenosis as the main pathological feature.(2)Early treatment to control the pulmonary artery pressure can improve the prognosis of patients with PH in pregnancy.Conclusion:Pulmonary artery pressure reduction therapy could improve the outcomes of the patients with PH in pregnancy.

关 键 词：妊娠 肺动脉高压 病因分析 重症监护治疗 

分 类 号：R714.7[医药卫生—妇产科学]