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目的：探讨高海拔地区妊娠晚期合并心衰剖宫产术过程中，在围手术期的更合理的综合治疗方法，并安全度过围手术期。方法：对在海拔２ ２６０ｍ ～３ ３００ｍ 地区５５例妊娠晚期合并心衰时用剖宫产结束妊娠患者为观察对象，在术前、术中及术后由麻醉医师、心内科医师及产科医师共同根据患者ＣＶＰ、ＳａＯ２、ＨＲ等连续监护，并采用综合有效地积极治疗，重症采用全麻ＰＥＥＰ，手术采用改良快速剖宫产术。结果：术前死亡１ 例，５４例经综合治疗同时行改良快速剖宫产术，产妇无术中、术后死亡，术中娩出新生儿全部存活１周以上，５４例孕产妇均安全渡过围手术期。结论：采用以心内科最新治疗技术为主的三科合作，利用改良快速剖宫产术，从切皮到胎儿娩出５ｍ ｉｎ 以内完成以及２０ｍ ｉｎ 左右完成手术全过程新术式，明显增加抢救成功率，对降低孕产妇合并心脏病死亡率有重要意义。
OBJECTIVE: To explore a more rational and comprehensive treatment during perioperative period in cesarean section with high-altitude pregnancy complicated with heart failure in the third trimester of pregnancy. Methods: Fifty-five patients with late pregnancy complicated with heart failure in the area of 2 260m ~ 3 300m altitude were enrolled in this study. Patients undergoing cesarean section termination of pregnancy were observed before, during and after surgery by anesthesiologists, cardiologists and obstetricians According to patients CVP, SaO2, HR and other continuous monitoring, and the use of comprehensive and effective active treatment, severe general anesthesia with PEEP, surgery using modified fast cesarean section. Results: One patient died preoperatively and 54 patients undergoing combined cesarean delivery at the same time were improved. No maternal and postoperative death occurred. All the newborn infants survived more than one week and 54 pregnant women were safe Perioperative period. Conclusion: The three-departmental cooperation based on the latest medical treatment of cardiology, the use of modified rapid cesarean section, completed from within 5 mins of the skin incision to the fetus and completed about 20 m in new surgical procedures, significantly increased the success of the rescue Rate, reduce maternal mortality associated with heart disease is of great significance.