妊娠合并预激综合征的临床分析  

Clinical analysis of pregnancy with pre-excitation syndromes

作　　者：徐淑婷 黄丹丹 肖淑珠 张平 林波[1] XU Shu-ting;HUANG Dan-dan;XIAO Shu-zhu(ECG Examination Room,Maternal and Child Health Hospital of Longgang District,Shenzhen 518172,China)

机构地区：[1]深圳市龙岗区妇幼保健院心电图检查室,518172

出　　处：《中国实用医药》2022年第24期65-68,共4页China Practical Medicine

基　　金：深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(项目编号:LGKCYLWS2020154)。

摘　　要：目的探讨妊娠合并预激综合征的临床特点及防治对策。方法回顾性分析50例妊娠合并预激综合征孕妇的临床资料,观察其心电图的表现形式,分析预激综合征的诊断与妊娠时间关系,妊娠合并预激综合征的室上性心动过速(SVT)发作情况、临床特点及治疗情况,以及妊娠合并预激综合征孕妇的妊娠结局。结果50例妊娠合并预激综合征孕妇根据心电图表现分为显性预激33例,间歇性预激14例,隐匿性预激3例。间歇性预激者中11例在妊娠结束后心室预激波消失,心电图恢复正常。妊娠前诊断出预激综合征8例(16%),妊娠期首次诊断出42例(84%)。妊娠期首次诊断的42例孕妇中有34例(81%)在第1胎时诊断出预激综合征,其中有2例发生阵发性SVT;8例(19%)在第2胎时诊断预激综合征孕妇,有3例发作SVT。13例(26%)预激综合征孕妇妊娠期出现心悸、胸闷等症状,包括合并SVT 7例,房性早搏2例,室性早搏1例,窦性心动过缓1例,窦性心动过速2例,无心房颤动、心房扑动(AFL);37例(74%)预激综合征孕妇妊娠期无任何自觉症状,不需特殊处理。7例发作SVT孕妇中6例为妊娠期间首次发作,其中孕早期1例,孕中期2例,孕晚期3例,产褥期1例。SVT发作孕妇有2例妊娠前有SVT发作,5例妊娠前无SVT发作。妊娠合并预激综合征SVT发作孕妇与无SVT发作孕妇平均孕周、新生儿出生体重及分娩方式比较,差异无统计学意义(P>0.05)。无孕妇于分娩过程中发作心律失常。结论健康女性可在婚检、备孕前进行心电图检查,筛查心律失常。既往有预激综合征病史及妊娠后确诊预激综合征的女性,妊娠期间由妇产科医生和心内科医生建立规范的管理流程,如果孕期发生心律失常,则给予相应的心内科处理,并增加产前检查的频率,减少或避免对母婴的伤害,有利于获得良好的妊娠结局。Objective To discuss the clinical characteristics and prevention strategies of pregnancy complicated with pre-excitation syndrome.Methods The clinical data of 50 pregnant women with pre-excitation syndrome were retrospectively analyzed.The manifestations of electrocardiogram was observed,and the correlation between the diagnosis of pre-excitation syndrome and time to pregnancy,the episode of supraventricular tachycardia(SVT),clinical features and treatment,and the pregnancy outcomes of pregnant women with pre-excitation syndrome were analyzed.Results 50 pregnant women with pre-excitation syndrome were classified into 33 cases of overt pre-excitation,14 cases of intermittent pre-excitation,and 3 cases of occult pre-excitation according to the electrocardiographic manifestations.For intermittent pre-excitation,11 cases of ventricular pre-excitation disappeared after pregnancy,and the electrocardiogram returned to normal.Preexcitation syndrome was diagnosed before pregnancy in 8 cases(16%)and was diagnosed for the first time during pregnancy in 42 cases(84%).Of the 42 pregnant women diagnosed for the first time during pregnancy,34 cases(81%)were diagnosed with pre-excitation syndrome in their first pregnancy,of which 2 cases had paroxysmal SVT;8 cases(19%)were diagnosed with pre-excitation syndrome in their second pregnancy,of which 3 cases had SVT.13 cases(26%)of pregnant women with pre-excitation syndrome had palpitations and chest tightness during pregnancy,including 7 cases with SVT,2 cases of premature atrial beats,1 case of premature ventricular beats,1 case of sinus bradycardia,2 cases of sinus tachycardia,and no atrial fibrillation or atrial flutter(AFL);37 cases(74%)of pregnant women with pre-excitation syndrome did not have any conscious symptoms during pregnancy and did not require special treatment.Among the 7 cases of SVT,6 cases had their first episode during pregnancy,including 1 case in early pregnancy,2 cases in mid-pregnancy,3 cases in late pregnancy,and 1 case in the puerperium.In pregnant women w

关 键 词：妊娠 预激综合征 室上性心动过速 

分 类 号：R714.25[医药卫生—妇产科学]