超声心动图在监测妊高征患者心功能中的应用价值及对其妊娠结局的影响

摘要

Objective To explore the value of echocardiography in monitoring cardiac function of patients with pregnancy induced hypertension and its effect on pregnancy outcome.Methods From October 2014 to October 2016,In our hospital 39 pregnancy-induced hypertension patients were selected as observ ation group,39 healthy pregnant women during the same period were selected as control group.Both groups underwent echocardiography examination,cardiac morphological indicators [left ventricular mass index (LVMI),left ventricular relative wall thickness (RWT),left ventricular end-diastolic diameter (LVDd),left ventricular end systolic diameter (LAD),end-diastolic interventricular septum thickness (IVSTd),left ventricular posterior wall diastolic thickness (LVPWTd)],cardiac function index[early diastolic blood flow velocity (E),late diastolic maximum velocity (A),E/A ratio,left ventricular ejection fraction (LVEF),early diastolic fast filling fraction (RFF),cardiac output (CO),cardiac index (CI)]of the two groups were analyzed,then the observation group was divided into observation group A (n=20) and observation group B (n=19),according to the echocardiographic assessment results,group A was given the corresponding intervention,and the two groups were followed up or induced labor,pregnancy outcomes of the two groups were analyzed.Results The LVMI,RWT,LVDd,LAD,IVSTd and LVPWTd levels in observation group were significantly higher than those in control group (P＜20.05);the A value of the observation group was higher than that of the control group,and RFF and E/A value were significantly lower than those in the control group (P＜0.05);there was no significant difference in E value,LVEF,CI and CO levels between the two groups (P＞0.05);the cesarean section rate in observation group A was lower than that in observation group B,and neonatal asphyxia,postpartum hemorrhage,premature delivery and other adverse pregnancy outcomes incidence was significantly lower than that in observation group B (P＜0.05).Conclusion Treatment of pregnancy-induced hypertension patients with echocardiography can effectively detect heart morphology and cardiac dysfunction,thus contributing to early detection of heart failure,and according to echocardiographic assessment results,some corresponding intervention measures will help improve pregnancy outcome.%目的 探讨超声心动图在监测妊高征患者心功能中的应用价值及对其妊娠结局的影响.方法 选取2014年10月-2016年10月在我院39例妊高征患者作为观察组,另取同期39例体检健康孕妇作为对照组.两组均行超声心动图检查,统计两组心脏形态指标[左心室重量指数(LVMI)、左心室相对室壁厚度(RWT)、左心室舒张末期内径(LVDd)、左室收缩末期内径(LAD)、室间隔舒张末期厚度(IVSTd)、左室后壁舒张期厚度(LVPWTd)]、心功能指标[舒张早期最大血流速度(E)、舒张晚期最大血流速度(A)、E/A比值、左室射血分数(LVEF)、舒张早期快速充盈分数(RFF)、心输出量(CO)、心脏指数(CI)]水平,将观察组分为观察A组(n=20)与观察B组(n=19),根据超声心动图评估结果,给予观察A组对应干预措施,并对两组进行随访或引产,统计两组妊娠结局.结果 观察组LVMI、RWT、LVDd、LAD、IVSTd、LVPWTd水平高于对照组,差异有统计学意义(P＜0.05);观察组A值大干对照组,RFF及E/A值小于对照组,差异有统计学意义(P＜0.05);两组E值、LVEF、CI、CO水平差异无统计学意义(P＞0.05);观察A组剖宫产率低于观察B组,且新生儿窒息、产后出血、早产等不良妊娠结局发生率低于观察B组,差异有统计学意义(P＜0.05).结论 给予妊高征患者超声心动图检查,可有效检出心脏形态及心功能异常,进而有助于早期发现心衰,且根据超声心动图评估结果制定对应干预措施,有利于改善妊娠结局.