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目的探讨风湿性二尖瓣狭窄合并妊娠患者,于妊娠中晚期行经皮二尖瓣球囊扩张术的可行性及安全性。方法总结5例风湿性二尖瓣狭窄合并妊娠者于妊娠中晚期行经皮二尖瓣球囊扩张术的临床资料。结果5例孕妇术后二尖瓣口面积由术前的平均(0.83±0.24)cm2(0.57～1.15cm2)扩大到术后的平均(1.94±0.1)cm2(1.80～2.05cm2);心功能术前III级2例,术后至围生期I级2例,II级3例。5例婴儿发育均正常。5例孕妇中除4例术后合并轻度二尖瓣反流外,未发生严重并发症。结论经皮二尖瓣球囊扩张术对于出现急性肺水肿和咯血的风湿性心脏病二尖瓣狭窄妊娠中晚期患者,是可行并且安全有效的急救方法。
Objective To investigate the feasibility and safety of percutaneous balloon mitral valvuloplasty in patients with rheumatic mitral stenosis and pregnancy. Methods The clinical data of 5 patients with rheumatic mitral stenosis complicated with pregnancy who underwent percutaneous balloon mitral valvuloplasty in the second trimester of pregnancy were summarized. Results The postoperative mitral valve area of 5 pregnant women was increased from 0.73 ± 0.24 cm2 (0.57 ~ 1.15 cm2) to 1.94 ± 0.1 cm2 (1.80 ~ 2.05 cm2) There were 2 cases in the former stage III, 2 cases in stage I after perinatal period and 3 cases in stage II. 5 cases of normal infant development. In 5 pregnant women, except for 4 cases with postoperative mild mitral regurgitation, no serious complications occurred. Conclusion Percutaneous balloon mitral valvuloplasty is a feasible and safe first aid method for patients with middle-late stage of pregnancy with rheumatic mitral stenosis and acute pulmonary edema and hemoptysis.