妊娠合并肺动脉高压10例临床分析

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1、·268·实用妇产科杂志2010年4月第26卷第4期JournalofPracticalObstetricsandGynecology2010眦26，No．4文章编号：1003～6946(2010)04—268—04妊娠合并肺动脉高压10例临床分析张丽娟，曾鸿波(中南大学湘雅二医院，湖南长沙410011)【摘要】目的：分析妊娠合并肺动脉高压(PH)的临床特点，探讨其妊娠分娩时机及围生期监测治疗措施。方法：回顾性分析我院2005年6月至2009年1月10例妊娠合并PH患者的临床资料。结果：原发性肺动脉高压(PPH)1例，继发性肺动脉高压(SPH)9例(风

2、湿性心脏病4例、先天性心脏病5例)；轻度PH3例，中度PH6例，重度PH1例；心功能I～Ⅱ级4例，心功能Ⅲ一Ⅳ级6例；足月分娩4例，早产5例，早孕人工流产1例；剖宫产8例，阴道分娩l例；产妇死亡l例，极低出生体重儿2例，新生儿死亡1例。结论：PPH患者应避免妊娠，SPH患者依心功能、肺动脉压力高低决定是否妊娠，最好在手术或药物治疗后妊娠。中、重度PH患者妊娠后建议早期终止妊娠，中晚期妊娠患者以剖宫产终止妊娠为宜。产妇和新生儿的预后取决于多种因素的影响。【关键词】妊娠合并肺动脉高压；临床特点；治疗；预后中图分类号：R714．252文献标识码：APulmo

3、naryHypertensionComplicationPregnancy：Analysisof10CasesZHANGLijuan。ZENGHongbo(TheSecondAfiliatedHospitalofSouthCentralUniversity，ChangshaHunan410011。China)【Abstract】Objective：Toanalysistheclinicalcharacteristicsofpulmonaryhypertension(PH)complicatingpregnancy，thentoexplorethedel

4、iverytimeandthemonitoringaswellasthetreatmentduringperinatalperi-od．Methods：Thedataof10caseswithPHtreatedinourhospitalfr0mJune20o5toJanuary2009wereretro-speotivelyanalyzed．Results：1casewasprimarypulmonaryhypertension(PPH)；9casesweresecondaryPH(SPH)。inwhich4caseswererheumatichear

5、tdiseaseand5caseswerecongenitalheartdiseases．3caseswereslightPH。6casesweremoderatePH，and1wereseveregroup．4casesNYHAclasswere卜IIand6casesNYHAclasswerem—IV．4casesweretermdelivery，5caseswereprematuredelivery，and1gotartifi—cialabortion．8caseswerecesareansection，and1wasvaginaldeliver

6、y．2caseswereverylowbirthweightinfants．1infantwasdeathand1motherwasdeath．Conclusions：ThepatientofPPHshouldavoidconcai-ving．ForSPHpatientswhethertoconceivedependsoncardiacfunction，thelevelofpulmonaryartedalpres-sureandshouldbettergetpregnancyaftersurgeryormedication．Itshouldtermin

7、atepregnancyinthefirsttri·meterformoderateorseverepatients．Cesareansectionismoresuitableforthoseinthesecondorthirdtri·mester．Theprognosisofthemotherandneonatedependsonseveralfactors．【Keywords】Pulmonaryhypertensioncomplicatingpregnancy；Clinicalcharacteristics；Treatment；Prognosis妊

8、娠合并肺动脉高压(pulmonaryhypertension，PH)是一种较少见的疾病，但严重