Clinical Analysis of 21 Patients with Cardiac Surgery by Cardiopulmonary Bypass during Pregnancy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

藍永榮 , 韓濤 , 陳同

福建醫科大學省立醫院心外科(福州 350001);

Corresponding?author：

Keywords：

妊娠期; 體外循環手術; 母嬰結局

DOI：

10.7507/1007-4848.20160150

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目的探討妊娠期體外循環手術的圍術期處理方法及母嬰安全性。方法回顧性分析2006年1月至2014年3月福建省立醫院心外科21例妊娠期行體外循環手術患者的臨床資料，年齡（26.2±3.4）歲。結果母親19例生存，2例死于多器官功能衰竭。嬰兒6例引產，2例死亡，生存13例。隨訪13例存活新生兒8個月至8年，并對4例年齡大于6歲的兒童進行韋氏兒童智力量表第4版（WISC-IV）測試，得分分別為92分、104分、106分、90分，平均98分，與正常兒童無明顯差異[（100±15）分]。結論體外循環下心臟手術對于妊娠期合并嚴重心臟病患者是可行的，手術的危險性主要取決于手術方式、手術時間、孕周、體外轉流時間、是否深低溫等，應采取多學科合作，根據患者具體情況制定個體化方案。

Citation： 藍永榮, 韓濤, 陳同. Clinical Analysis of 21 Patients with Cardiac Surgery by Cardiopulmonary Bypass during Pregnancy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(6): 631-633. doi: 10.7507/1007-4848.20160150 Copy

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2.	Barth WH Jr. Cardiac surgery in pregnancy. Clin Obstet Gynecol, 2009, 52(4):630-646.
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6.	王歡迎, 張軍, 李斌, 等. 妊娠期體外循環下心臟手術孕婦的母兒結局分析. 中華婦產科雜志, 2014, 2(2):104-108.
7.	Johnston C, Schroeder F, Fletcher SN, et al. Type A aortic dissection in pregnancy. Int J Obstet Anesth, 2012, 21(1):75-79.
8.	Papatsonis DN, Heetkamp A, van den Hombergh C, et al. Acute type A aortic dissection complicating pregnancy at 32 weeks:surgical repair after cesarean section. Am J Perinatol, 2009, 26(2):153-157.
9.	李彤, 段大為, 胡曉旻, 等. 妊娠期合并心血管疾病的手術方法及文獻復習. 中國胸心血管外科臨床雜志, 2007, 4(2):150-151.
10.	何發明, 王平凡, 梁志強, 等. 妊娠期心臟直視手術6例. 中華胸心血管外科雜志, 2009, 8(4):268-269.
11.	Yuan SM. Indications for cardiopulmonary bypass during pregnancy and impact on fetal outcomes. Geburtsh Frauenheilk, 2014, 74:55-62.

1. John AS, Gurley F, Schaff HV, et al. Cardiopulmonary bypass during pregnancy. Ann Thorac Surg, 2011, 91(4):1191-1196.
2. Barth WH Jr. Cardiac surgery in pregnancy. Clin Obstet Gynecol, 2009, 52(4):630-646.
3. Dubourg G, Broustet P, Bricaud H, et al. complete correction of a triad of Fallot, in extracorporeal circulation, in a pregnant woman. Arch Mal Coeur Vaiss, 1959, 52:1381-1391.
4. Neema PK. Cardiopulmonary bypass during pregnancy——fetal demise:an enigma. Ann Card Anaesth, 2014, 17(1):1-3.
5. Mishra M, Sawhney R, Kumar A, et al. Cardiac surgery during pregnancy:continuous fetal monitoring using umbilical artery Doppler flow velocity indices. Ann Card Anaesth, 2014, 17(1):46-51.
6. 王歡迎, 張軍, 李斌, 等. 妊娠期體外循環下心臟手術孕婦的母兒結局分析. 中華婦產科雜志, 2014, 2(2):104-108.
7. Johnston C, Schroeder F, Fletcher SN, et al. Type A aortic dissection in pregnancy. Int J Obstet Anesth, 2012, 21(1):75-79.
8. Papatsonis DN, Heetkamp A, van den Hombergh C, et al. Acute type A aortic dissection complicating pregnancy at 32 weeks:surgical repair after cesarean section. Am J Perinatol, 2009, 26(2):153-157.
9. 李彤, 段大為, 胡曉旻, 等. 妊娠期合并心血管疾病的手術方法及文獻復習. 中國胸心血管外科臨床雜志, 2007, 4(2):150-151.
10. 何發明, 王平凡, 梁志強, 等. 妊娠期心臟直視手術6例. 中華胸心血管外科雜志, 2009, 8(4):268-269.
11. Yuan SM. Indications for cardiopulmonary bypass during pregnancy and impact on fetal outcomes. Geburtsh Frauenheilk, 2014, 74:55-62.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Analysis of 21 Patients with Cardiac Surgery by Cardiopulmonary Bypass during Pregnancy

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