妊娠期心瓣膜置换术围术期的治疗进展

妊娠期妇女的心脏病发病率为1％～4％，其中以风湿性心瓣膜疾病最为常见。在内科治疗无效的情况下，则需要进行手术干预。由于妊娠期特有的生理改变，妊娠期患者的心瓣膜置换术围术期处理与非妊娠期患者相比有较大的差异。目前，对妊娠期患者行体外循环心脏手术已不是绝对禁忌证，但胎儿的死亡率和致畸率仍然很高。目前在心瓣膜置换术围术期对体外循环方法、术后监护和抗凝等方面的不断改进，将有助于减少并发症，提高生存率。现就近年来妊娠期心瓣膜置换术围术期的治疗进展进行综述。

Progress in Perioperative Treatments of Cardiac Valve Replacement during Pregnancy

There is a 1%-4% incidence of cardiac disease in pregnancy,and rheumatic heart disease is the most common diagnosis.On the condition that medical treatment is inefficacious,an open heart surgery should be performed.Because of the changes in physiological functions,there is a major difference between pregnant patients and the general population in perioperative management of valve replacement.Now,the pregnancy is not an absolute contraindication for cardiopulmonary bypass,though the incidence of mortality and birth defects remains high.It is helpful in decreasing complications and increasing survival rate by improving the methods of cardiopulmonary bypass,postoperative monitoring,anticoagulation etc.In this article,the progress in treatments of perioperative period of cardiac valve replacement during pregnancy is reviewed.