2023 年第 9 期 第 18 卷

妊娠合并感染性心内膜炎的临床治疗及母婴结局分析

Clinical treatment and maternal and infant outcome analysis in pregnancy with infectious endocarditis

作者：邓越王克芳

英文作者：Deng Yue Wang Kefang

单位：首都医科大学附属北京安贞医院妇产科，北京100029

英文单位：Department of Obstetrics and Gynaecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：感染性心内膜炎；妊娠结局；心脏手术；体外循环

英文关键词：Infectiveendocarditis;Maternalandinfantoutcomeoutcomes;Cardiacsurgery;On-pump

• 摘要：

• 目的  探讨妊娠合并感染性心内膜炎(IE)患者的临床治疗及母婴结局。方法 回顾性分析2012年8月至2022年8月首都医科大学附属北京安贞医院收治的11例妊娠合并 IE 患者的临床资料。包括患者的临床特征、术前抗菌药物治疗情况、手术时机及方式、术中及术后管理及孕妇胎儿转归情况，总结妊娠合并IE诊断、治疗的临床策略。结果 11例患者均有发热症状，体格检查均有心脏杂音。5例患者患有先天性心脏病。11例患者中，10例患者孕期进行心脏手术，6例患者心脏手术前进行剖宫产术。11例患者中，10例患者行剖宫手术终止妊娠，1例患者经阴道分娩，11例患者均痊愈出院。11例胎儿中，2例剖宫取胎术未存活，2例为足月儿，7例为早产儿。结论 手术治疗妊娠合并IE是一种安全、有效的方式。

• Objective To explore the clinical treatment and maternal and infant outcome in pregnant patients with infectious endocarditis(IE). Methods From August 2012 to August 2022, clinical features of 11 pregnant patients with IE in Beijing Anzhen Hospital，Capital Medical University were analyzed retrospectively, including clinical data of the patients, preoperative antibiotic treatment status, surgical timing and methods , intraoperative and postoperative management, and maternal and fetal outcomes. Clinical strategies for the diagnosis and treatment of pregnancy with IE were summarized. Results All the 11 patients had fever symptoms and heart murmurs on physical examination, and 5 patients had congenital heart disease. Among the 11 patients, 10 patients underwent cardiac surgery during pregnancy, 6 patients underwent cesarean section before cardiac surgery, 10 patients underwent cesarean section to terminate pregnancy, 1 patient underwent vaginal delivery, and all the 11 patients recovered and were discharged. Among the 11 fetuses, 2 cases of cesarean section and fetal retrieval surgery did not survive, 2 cases were term infants, and 7 cases were premature infants. Conclusions  Surgical treatment of pregnancy with IE is a safe and effective method.