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

Authors：

蓝永荣 , 韩涛 , 陈同

福建医科大学省立医院心外科(福州 350001);

Corresponding author：

Keywords：

妊娠期; 体外循环手术; 母婴结局

DOI：

10.7507/1007-4848.20160150

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目的探讨妊娠期体外循环手术的围术期处理方法及母婴安全性。方法回顾性分析2006年1月至2014年3月福建省立医院心外科21例妊娠期行体外循环手术患者的临床资料，年龄（26.2±3.4）岁。结果母亲19例生存，2例死于多器官功能衰竭。婴儿6例引产，2例死亡，生存13例。随访13例存活新生儿8个月至8年，并对4例年龄大于6岁的儿童进行韦氏儿童智力量表第4版（WISC-IV）测试，得分分别为92分、104分、106分、90分，平均98分，与正常儿童无明显差异[（100±15）分]。结论体外循环下心脏手术对于妊娠期合并严重心脏病患者是可行的，手术的危险性主要取决于手术方式、手术时间、孕周、体外转流时间、是否深低温等，应采取多学科合作，根据患者具体情况制定个体化方案。

Citation： 蓝永荣, 韩涛, 陈同. 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

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.	王欢迎, 张军, 李斌, 等. 妊娠期体外循环下心脏手术孕妇的母儿结局分析. 中华妇产科杂志, 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, 段大为, 胡晓旻, 等. 妊娠期合并心血管疾病的手术方法及文献复习. 中国胸心血管外科临床杂志, 2007, 4(2):150-151.
10.	何发明, 王平凡, 梁志强, 等. 妊娠期心脏直视手术6例. 中华胸心血管外科杂志, 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. 王欢迎, 张军, 李斌, 等. 妊娠期体外循环下心脏手术孕妇的母儿结局分析. 中华妇产科杂志, 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, 段大为, 胡晓旻, 等. 妊娠期合并心血管疾病的手术方法及文献复习. 中国胸心血管外科临床杂志, 2007, 4(2):150-151.
10. 何发明, 王平凡, 梁志强, 等. 妊娠期心脏直视手术6例. 中华胸心血管外科杂志, 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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