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1、妊娠合并肺动脉高压诊断及治疗［摘要］目的:探讨妊娠合并肺动脉高压的临床表现、诊断和治疗。方法:回顾分析2例妊娠合并肺动脉高压患者的临床资料。结果:第1例患者为妊娠合并继发性肺动脉高压，孕35周剖宫产，术后5d岀现胸闷、呼吸困难、发纟甘，最终抢救无效死亡，临床考虑肺小动脉栓塞。第2例为双胎合并原发性肺动脉高压，因孕34+2周，双胎，活动后胸闷、心悸1周入院。于孕35周剖宫产，产后胸闷、心悸一度加重，经对症治疗好转,产后3周平安出院。结论:妊娠合并肺动脉高压母儿结局不良,患者不宜妊娠。一旦妊娠应早期终止。拒绝终止妊娠者，应加强监护，尤其要监测肺动脉高压和低氧血症的情况。［关键词］肺动脉高压;
2、妊娠并发症;诊断;治疗［中图分类号JR714.24+6［文献标识码］B［文章编号］1673-7210(2009)07(3)-197-02DiagnosisandtreatmentofpulmonaryhypertensionduringpregnancyWANGYanhong(DepartmentofGynecologyandObstetrics,GeneralHospitalofPuyangOilField,Puyang457001,China)[Abstract]Objective:Toinvestigateclinicalpresentation‘diagnosisandtreat
3、mentofpulmonaryhypertensionduringpregnancy.Methods:Twopatientswithpulmonaryhypertensionduringpregnancywerereportedretrospective!y.Results:Thefirstcasewassecondarypulmonaryhypertensionduringpregnaney.CesareanSectionwasperformedat35weeks.Shehadchestdistress,dyspneaandcyanosisafterfivedays,anddiedfi
4、nally.Thediagnosisofpulmonaryembolismwashighlysuspectedclinically.Thesecondcasewasadmittedbecauseoftwinpregnancyandchestdistress,palpitationduringdailylifeforoneweek・Shewasprimarypulmonaryhypertension.CesareanSectionwasperformedat35weeks.ThechestdistressandpalpitationworsenedafterCesareanSection.
5、Theabove-mentionedsymptomsimprovedafterexpectanttreatment.Shewasdischargedfromthehospitalthreeweeksafterdelivery.Conclusion:Pulmonaryhypertensionduringpregnancywasassociatedwithextremelypoormaternalandfataloutcome・Pregnancyiscontraiindicatedinsuchpatients.Pregnancyshouldbeterminatedasearlyaspossi
6、bleinsuchwomen.Incasewhointendstocontinuethepregnancy,closeobservation‘especiallyofpulmonaryhypertensionandhypoxemia,mustbeprovided.[Keywords]Pulmonaryhypertension;Pregnancycomplications;Diagnosis;Therapy心脏病肺动脉高压(pulmonaryhypertension,PH),包括原发性肺动脉高压(primarypulmonaryhypertension,PPH)和继发性肺动脉高压。原发性肺
7、动脉高压是指原因不明的肺动脉高压,继发性肺动脉高压是指除外PHH外,所有其他类型的有原因可寻的肺动脉高压，如风心病、先心病等。妊娠合并心脏病肺动脉高压是一种较少见的疾病,严重威胁母儿生命。现报道我院2例妊娠合并肺动脉高压,以引起产科医生的重视。1临床资料第1例:患者26岁，孕3产0,孕36+5周,活动后胸闷、心悸、发纟甘2个月入院。自幼青紫，偶有心悸、气促，日常生活能自理。2002年在郑州空军医院诊为先天性心脏病(室缺、动脉导管未闭
