患者34岁，孕6产2，因"停经25+4周，恶心、呕吐伴下腹痛8+ h"于2021年8月10日04：32收入深圳市龙岗区妇幼保健院妇科。入院前1周曾在外院行口服葡萄糖糖耐量试验(oral glucose tolerance test, OGTT)示：空腹血糖5.09 mmol/L，餐后1 h血糖11.11 mmol/L，餐后2 h血糖9.15 mmol/L，诊断妊娠期糖尿病，予以饮食运动指导，未规律检测血糖。入院前1天(8月9日)早餐进食糯米团等碳水化合物，出现口渴、多饮、多尿，8月9日夜间上述症状加重，19：00时进食牛奶后出现恶心，呕吐4次为胃内容物，伴下腹隐痛、腰部酸痛、坠胀感，有头痛、心慌、胸闷，无抽搐、昏迷。

目的 探讨妊娠合并预激综合征的临床特点及防治对策.方法 回顾性分析50例妊娠合并预激综合征孕妇的临床资料,观察其心电图的表现形式,分析预激综合征的诊断与妊娠时间关系,妊娠合并预激综合征的室上性心动过速(SVT)发作情况、临床特点及治疗情况,以及妊娠合并预激综合征孕妇的妊娠结局.结果 50例妊娠合并预激综合征孕妇根据心电图表现分为显性预激33例,间歇性预激14例,隐匿性预激3例.间歇性预激者中11例在妊娠结束后心室预激波消失,心电图恢复正常.妊娠前诊断出预激综合征8例(16％),妊娠期首次诊断出42例(84％).妊娠期首次诊断的42例孕妇中有34例(81％)在第1胎时诊断出预激综合征,其中有2例发生阵发性SVT;8例(19％)在第2胎时诊断预激综合征孕妇,有3例发作SVT.13例(26％)预激综合征孕妇妊娠期出现心悸、胸闷等症状,包括合并SVT 7例,房性早搏2例,室性早搏1例,窦性心动过缓1例,窦性心动过速2例,无心房颤动、心房扑动(AFL);37例(74％)预激综合征孕妇妊娠期无任何自觉症状,不需特殊处理.7例发作SVT孕妇中6例为妊娠期间首次发作,其中孕早期1例,孕中期2例,孕晚期3例,产褥期1例.SVT发作孕妇有2例妊娠前有SVT发作,5例妊娠前无SVT发作.妊娠合并预激综合征SVT发作孕妇与无SVT发作孕妇平均孕周、新生儿出生体重及分娩方式比较,差异无统计学意义(P>0.05).无孕妇于分娩过程中发作心律失常.结论 健康女性可在婚检、备孕前进行心电图检查,筛查心律失常.既往有预激综合征病史及妊娠后确诊预激综合征的女性,妊娠期间由妇产科医生和心内科医生建立规范的管理流程,如果孕期发生心律失常,则给予相应的心内科处理,并增加产前检查的频率,减少或避免对母婴的伤害,有利于获得良好的妊娠结局.

目的:分析心肌酶谱和心电图在重症肺炎患儿的改变以及相关性.方法:将2017年3月至2019年3月就诊的120例儿童纳入研究,其中40名身体健康儿童为对照组,40例普通肺炎患儿为A组,40例重症肺炎患儿为B组.通过血清生化检验测定三组研究对象心肌酶谱中的乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)以及肌酸激酶(CK).观察三组研究对象心电图改变情况,分析心肌酶谱和心电图改变和肺炎的相关性.结果:B组LDH、CK-MB、AST以及CK指标均高于对照组和A组(P<0.05),B组心电图异常率高于对照组和A组(P<0.05);在肺炎患儿中,心肌酶谱变化、心电图异常与肺炎严重程度呈正相关(P<0.05).结论:重症肺炎患儿心肌酶谱明显上升,心电图异常率更高,两者的改变与肺炎严重程度存在密切关系,在临床儿童重症肺炎的诊治中具有重要的参考价值.

目的 探讨二代胎儿心电图检查对检测异常胎儿的临床价值.方法 把2019年1月至2019年7月在深圳市龙岗区妇幼保健院进行产检的433例产妇分为3组:产检无异常的健康孕妇300例为A组;产检存在异常情况的70例为B组;母体合并内科疾病的63例为C组.对比3组孕妇的胎儿心电图阳性率.结果 3组孕妇组对比,B组的胎儿心电图异常检出率(44.29％)高于A组(1％)和C组(15.87％).3组数据资料对比有统计学意义.结论 第二代胎儿心电图可以及时发现胎儿的心律失常,值得广泛运用于产检.

Objective By tracking the abnormal fetal electrocardiography ( FECG) cases with gestational age≥16 weeks, the most common electrocardiographic findings and early diagnostic value of intrauterine ischemia and hypoxia were explored. Methods Since the second-generation four-channel FECG technology was implemented in Longgang Women and Children Health Care Hospital in June 2015, a total of 37,000 pregnant women aged≥16 weeks were screened by March 2017. 305 pregnant women with intrauterine ischemia and hypoxia were selected as the study group. 300 pregnant women with same gestational age and no intrauterine ischemia and hypoxia were selected as the control group. The FECG performance of the two groups was compared and different ischemia and hypoxia were analyzed. The composition of the abnormal FECG factors was compared between the two groups. Results The proportion of disordered fetal arrhythmia and FST segment abnormal deviation in the study group was 88.20 % and 7.21 % , which was significantly higher than that of the control group (0.67 % , 0.33 % ). The difference was statistically significant(P<0.05). The causes of fetal ischemia and hypoxia were 75 cases of umbilical cord, 21 cases of oligohydramnios, 26 cases of pregnancy induced hypertension, 103 cases of intrauterine distress, 69 cases of infection and 11 cases of other cases. The electrocardiogram showed disordered arrhythmia. The composition ratios were 96.00 % , 76.19 % , 88.46 % , 86.41 % , 85.51 % and 90.91 % , respectively, which were significantly higher than the ST segment abnormal deviation and heart rate fluctuations, and the differences were statistically significant (P<0.05). The incidence of adverse outcomes such as neonatal asphyxia in the study group was 20.33 % , which was significantly higher than that in the control group (2.33 % ). The difference was statistically significant ( P<0.05). Conclusion Intrauterine ischemia and hypoxia can cause abnormalities in FECG. The most common electrocardiogram is a disordered fetal arrhythmia, which is different from the ST-T segment change in adult ECG.

目的 探究研究阵发性胎儿心动过速临床诊断、治疗处理的新认知以及妊娠结局分析、临床效果和应用价值.方法 对行常规的胎儿超声心动图检查确诊为阵发性胎儿心动过速的103例,采用常压氧气疗法治疗的效果分析.结果 治疗后心律、心胸面积明显降低,心脏缩短分数上升.两组数据之间比较差异具有统计学意义(P＜0.05).阿氏评分结果98例大于8分,无窒息表现有5例,小于7分,存在窒息临床表现.结论 阵发性胎儿心动过速,90％以上与宫内缺血缺氧无关,常压氧疗法可以有效改善胎儿阵发性室上性心动过速,值得临床推广.

目的 探讨胎儿宫内缺血缺氧心电图的主要表现.方法 从本院2015年6月开展第二代四通道胎儿心电图技术检测的孕龄≥16周以上孕妇中选取305例胎儿宫内缺血缺氧病例进行追踪研究,对其心电图表现进行分析.结果 305例宫内缺血缺氧胎儿共有283例表现为胎儿心律失常,发生率为92.8％,主要表现为“紊乱型”的胎儿心律失常,其中又以胎儿心动过速、胎儿心动过缓交替性反复出现最为常见;有22例表现为FST段异常偏移,发生率为7.2％,差异有统计学意义(P＜0.05).结论 胎儿宫内缺血缺氧的心电图表现与成人表现存在差异,心电图以胎儿心律失常为主要表现.