妊娠期心衰处理及分娩结局的临床观察

目的探讨妊娠期心力衰竭不同处理方式、处理时机对妊娠结局影响。方法选取妊娠期心力衰竭患者210例,均为本院2017年2月—2018年2月收治,依据所采取的分娩方式、时机、心功能状态、心力衰竭控制时间分组,比较不同类型组别分娩结局。结果相较采取剖宫产终止妊娠组,经阴道分娩终止妊娠组新生儿窒息率居较高水平(P<0.05);剖宫产手术时机方面,介于32~36^+6孕周组,相较37~39^+6孕周组,低体质量儿率居更低水平(P<0.05)。剖宫产手术心力衰竭控制时间方面,≤48 h组,相较>48 h组,肺透明膜病率、新生儿窒息率居更低水平(P<0.05)。剖宫产手术心功能方面,心功能Ⅰ~Ⅱ者,相较Ⅲ~Ⅳ组,围产期死亡率、新生儿窒息率居更低水平(P<0.05)。结论针对临床收治的妊娠期心衰患者,宜采取剖宫产的方式终止妊娠,且终止妊娠时机宜在32~36^+6孕周内开展,同时,在进行剖宫产术时,需积极稳定产妇心功能。

Clinical Observation on the Treatment of Pregnancy Heart Failure and the Outcome of Delivery

Objective To investigate the effects of different treatment methods and timing of pregnancy heart failure on pregnancy outcome.Methods A total of 210 patients with heart failure during pregnancy were selected.They were all treated in our hospital from February 2017 to February 2018.They were grouped according to the delivery method,timing,heart function status,and heart failure control time,and the labor of different types was compared.ending.Results Compared with the group with cesarean termination,the rate of neonatal asphyxia was higher in the group with termination of vaginal delivery(P<0.05).The timing of cesarean section was between 32~36^+6 gestational weeks.Compared with the 37~39^+6 gestational week group,the rate of low body weight children was lower(P<0.05).Regarding the control time of cesarean section for heart failure,in the ≤48 h group,compared with the>48 h group,the rate of hyaline membrane disease and neonatal asphyxia rate were lower(P<0.05).In terms of cardiac function during cesarean section,those with cardiac function Ⅰ~Ⅱ had lower levels of perinatal mortality and neonatal asphyxia than those in group Ⅲ~Ⅳ(P<0.05).Conclusion For patients with clinically accepted heart failure during pregnancy,it is advisable to terminate the pregnancy by cesarean section,and the termination of pregnancy should be carried out within 32~36^+6 gestational weeks.At the same time,active and stable cesarean section Maternal heart function.