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目的探讨妊娠期高血压疾病并发心衰的诊断处理方法。方法回顾分析2000年1月至2009年12月我院收治的90例妊娠期高血压疾病并发心功能衰竭患者的临床资料。结果 90例妊娠期高血压疾病并发心功能衰竭病例中产前心衰72例(80%),产后心衰18例(20%)。双胎妊娠8例,三胎妊娠1例,多胎妊娠率10%,合并呼吸道感染14例(15.56%),低蛋白血症57例(63.30%)贫血33例(36.7%)。未做产前检查78例(86.7%),正规产前检查12例(13.3%),无孕产妇死亡。1例孕29+4周双胎,早产儿死亡。结论妊娠期高血压疾病本身或合并贫血、低蛋白血症、水肿、呼吸道感染和不恰当的扩容治疗,为该病的诱发因素;发病时治疗以强心、利尿、扩血管为主,适时终止妊娠,剖宫产是安全的分娩方式;积极治疗原发病、去除诱因、做好孕期宣教和产前检查、减少多胎妊娠率。
Objective To investigate the diagnosis and treatment of hypertensive disorders complicating pregnancy during pregnancy. Methods The clinical data of 90 patients with hypertensive disorders of pregnancy complicated with heart failure admitted from January 2000 to December 2009 in our hospital were retrospectively analyzed. Results Seventy patients (80%) with prenatal heart failure and 18 cases (20%) with postpartum heart failure were found in 90 cases of pregnancy-induced hypertension with heart failure. There were 8 cases of twin pregnancy, 1 case of triple pregnancy, 10 cases of multiple pregnancy, 14 cases (15.56%) with respiratory tract infection and 33 cases (36.7%) of 57 cases (63.30%) with hypoproteinemia. There were 78 cases (86.7%) without prenatal examination, 12 cases (13.3%) with regular prenatal examination, and no maternal death. One case of pregnancy 29 +4 twins, premature children died. Conclusions Hypertensive disorders in pregnancy itself or with anemia, hypoproteinemia, edema, respiratory infections and improper dilatation therapy is the predisposing factor for the disease; when the onset of treatment with cardiac, diuretic, vasodilator-based, timely termination Pregnancy, cesarean delivery is a safe mode of delivery; active treatment of the primary disease, removal of incentives, good prenatal education and prenatal care to reduce the rate of multiple pregnancy.