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目的探讨妊娠合并预激综合征围产期室上性心动过速发作特点及对妊娠结局的影响。方法对北京大学第三医院1993年1月至2009年6月间妊娠合并预激综合征38例住院分娩患者的临床资料进行回顾性分析。结果妊娠合并预激综合征患者围产期发作室上性心动过速(SVT)5例,占13.16%(5/38),共发作SVT29次;在妊娠28～36周末(51.72%,15/29)及妊娠13～27周末(34.48%,10/29)发作所占的比例最高。妊娠期SVT发作增加者占10.53%(4/38)。妊娠前确诊预激综合征且合并SVT(未治疗)7例患者中4例在妊娠期没有发作SVT。围产期出现的29次室上性心动过速发作中,7次(24.14%)通过刺激迷走反射、18次(62.07%)经药物治疗好转,4次(13.79%)发作行经食管心脏调搏心律恢复正常。预激综合征患者围产期室上性心动过速发作与未发作组相比,平均分娩孕周、新生儿出生体重及分娩方式差异均无统计学意义(P>0.05)。结论预激综合征患者少部分围产期室上性心动过速发作增加,可能与妊娠期血容量的快速增加有关;规范合理的治疗可以有效地控制妊娠期室上性心动过速发作,妊娠结局良好。
Objective To investigate the characteristics of the onset of perinatal supraventricular tachycardia in pregnancy combined with pre-excitation syndrome and its effect on pregnancy outcome. Methods The clinical data of 38 hospitalized patients with pregnancy-associated WPW syndrome in the Third Hospital of Peking University from January 1993 to June 2009 were analyzed retrospectively. Results In the first trimester of pregnancy, SVT was found in 5 patients (13.16%, 5/38) and in SVT (29 cohorts) respectively. At the end of 28-36 weeks of gestation (51.72%, 15 / 29) and 13-27 weeks of pregnancy (34.48%, 10/29) the highest proportion of seizures. The increase in gestational SVT accounted for 10.53% (4/38). Pre-pregnancy diagnosis of pre-excitation syndrome and merger SVT (untreated) 7 cases of 4 patients during pregnancy did not attack SVT. Of the 29 episodes of supraventricular tachycardia that occurred during the perinatal period, 7 (24.14%) were stimulated by vagus reflex, 18 (62.07%) were treated with medication, and 4 (13.79%) were transesophageal pacing Heart rate returned to normal. There was no significant difference in gestational age, newborn birth weight and mode of delivery between pre-WPG patients with perinatal supraventricular tachycardia and non-PT group (P> 0.05). Conclusions A small part of the patients with WPW syndrome may have an increased incidence of supraventricular supraventricular tachycardia, which may be related to the rapid increase of blood volume during pregnancy. Standardized and reasonable treatment can effectively control the incidence of supraventricular tachycardia during pregnancy and pregnancy The outcome is good.