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目的探讨重度子痫前期并发心功能不全的诱因、早期诊断和预防。方法对绍兴市妇幼保健院2006年1月至2010年1月期间收治的34例重度子痫前期并发心功能不全(孕前无心脏疾病)的患者和同期未发生心功能不全的87例重度子痫前期患者的临床资料进行回顾性分析和比较。结果心功能不全组的收缩压、舒张压、心率均高于无心功能不全组(差异有显著性,P<0.05);心功能不全组患者水肿、贫血、低白蛋白血症的程度均重于无心功能不全组患者(差异有显著性P<0.05);产前出现心功能不全25例,产时心功能不全1例,产后心功能不全8例;心功能不全组围产儿死亡率、新生儿窒息发生率及小于胎龄儿和足月小样儿的比例高于无心功能不全组(差异有显著性P<0.05)。结论重度子痫前期并发妊娠高血压性心脏病心功能不全病情重,可危及母儿生命,应积极治疗原发病、去除诱因。水肿、贫血、低白蛋白血症、不合理扩容及输液过量过速是妊娠高血压性心脏病心功能不全的常见诱发因素。加强产前检查可便于早发现早治疗,重视产时及产后心衰的预警。
Objective To investigate the causes, early diagnosis and prevention of severe preeclampsia complicated with cardiac insufficiency. Methods From January 2006 to January 2010 in Shaoxing Maternal and Child Health Hospital, 34 patients with severe preeclampsia who had cardiac insufficiency (no heart disease before pregnancy) and 87 patients with severe eclampsia without congenital heart failure Pre-clinical data of patients were retrospectively analyzed and compared. Results The systolic blood pressure, diastolic blood pressure and heart rate were significantly higher in patients with cardiac dysfunction than in patients without cardiac insufficiency (P <0.05). The degree of edema, anemia and hypoalbuminemia in patients with cardiac dysfunction were significantly higher than those in patients without cardiac dysfunction 25 cases of cardiac dysfunction, 1 case of cardiac dysfunction in 1 case, 8 cases of postpartum cardiac dysfunction; perinatal mortality in neonates with cardiac insufficiency, newborns The incidence of asphyxia and the proportion of infants younger than gestational age and full-term infants were significantly higher than those without cardiac insufficiency (P <0.05). Conclusion Severe preeclampsia complicated by hypertensive heart disease complicated with heart failure can endanger the mother’s life, should actively treat the primary disease, remove the cause. Edema, anemia, hypoalbuminemia, unreasonable expansion and infusion over-speed hypertensive heart disease is a common cause of cardiac dysfunction. Strengthen the prenatal examination can facilitate the early detection and early treatment, emphasis on early warning of labor and postpartum heart failure.