{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1869","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1869","topicTypeId":null,"topicThemeId":"1036","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"为您提供:先心病是怎么造成的_先心病 可以预防吗等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"先心病是怎么造成的_先心病 可以预防吗","title":"先心病是怎么造成的_先心病 可以预防吗","channels":null},"data":{"list":[{"id":"8498","isDel":0,"createAt":1512025666283,"createBy":"8b39c578b53311e7a3d800163e04584d","createName":"梅油油","updateAt":1526351141422,"updateBy":"8b39c578b53311e7a3d800163e04584d","updateName":"梅油油","userId":"8b39c578b53311e7a3d800163e04584d","title":"先天性心脏病要如何预防 ","content":"

先天性心脏病的预防常识非常重要，先天性心脏病大家都非常的熟悉，但是有不少的人都不知道要怎么样预防，其实预防这个疾病的方法好几种，下面我们一起来了解一下先天性心脏病的预防措施都有哪些?


 

\"先天性心脏病要如何预防

 

　　1、适龄婚育

 

　　医学已经证明，35岁以上的孕妇发生胎儿基因异常的风险明显增加。因此最好在35岁以前生育。如果无法做到这一点，那么建议高龄孕妇必须接受严格的围产期医学观察与保健。

 

　　2、准备要孩子前要做好心理、生理状态的调节

 

　　如果准妈妈有吸烟、饮酒等习惯，最好至少在怀孕前半年就要停止。

 

　　3、加强对孕妇的保健

 

　　特别是在妊娠早期积极预防风疹、流感等风疹病毒性疾病。孕妇应尽量避免服用药物，如必须使用，必须在医生指导下进行。

 

\"先天性心脏病要如何预防


　　4、孕期保护

 

　　尽量少接触射线、电磁辐射等不良环境因素。

 

　　5、孕期避免去高海拔地区旅游

 

　　因为已经发现高海拔地区的先天性心脏病发生率明显高于平原地区，可能与缺氧有关。

 

\"先天性心脏病要如何预防


　　6、必要的检查

 

　　母体在怀孕中期可进行胎儿心脏彩超，检查胎儿的心脏是否正常。


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对于先天性心脏病这种疾病相信大家都比较了解，都知道这种疾病给患者家庭所带来负担有多重，其实对于先天性心脏病，我们必须积极预防，下面我们就来详细讲讲如何预防先天性心脏病?


 

\"如何预防宝宝先天性心脏病\"


1、怀孕后，准妈妈不要接触有毒物质或者处于含有放射性的环境中。如今大城市里面空气越来越差了，尤其是雾霾天，当中会含有很多的有毒物质被准妈妈呼吸进入体内，有毒物质通过血液循环到宝宝身体里面就会变成宝宝先天性心脏病的根源。并且某些辐射比较强大的家用电器也会对准妈妈和胎儿造成直接的影响。

 

2.、要注意饮食习惯和营养均衡，准妈妈每天吃的食物都要是有规律的，不要有上一顿没有下一顿的，营养搭配也要合理，但是也不能一味地补充营养让自己变得过度肥胖，无论是哪种情况都不利于胎儿的健康发育。

 

3、怀孕后就不可以乱用药，最好的做法是，从备孕开始就不可以随便乱吃药，身体不舒服了要在第一时间去看医生，纠正自己的观点和心态，这样才能够让宝宝正常地生长发育。

 

4、抽烟喝酒也是造成宝宝先天性心脏病的重要原因，因此，要是你想要一个健健康康的宝宝，要学会养成良好的生活习惯，改掉一切的不良嗜好，这样才是对自己和对宝宝负责。

 

5、在宝宝出生以后，爸爸妈妈一定要经常留意孩子的身体状况，一旦发觉有什么不对劲，马上带宝宝去检查，千万别以为是小事，耽误久了会使病情更难以治疗。


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\"先天性心脏病的孕期预防\"

 

1、适龄婚育

 

医学已经证明，35岁以上的孕妇发生胎儿基因异常的风险明显增加。因此最好在35岁以前生育。如果无法做到这一点，那么建议高龄孕妇必须接受严格的围产期医学观察与保健。

 

2、准备要孩子前要做好心理、生理状态的调节

 

如果准妈妈有吸烟、饮酒等习惯，最好至少在怀孕前半年就要停止。

 

3、加强对孕妇的保健

 

特别是在妊娠早期积极预防风疹、流感等风疹病毒性疾病。孕妇应尽量避免服用药物，如必须使用，必须在医生指导下进行。

 

4、孕期保护

 

尽量少接触射线、电磁辐射等不良环境因素。

 

5、孕期避免去高海拔地区旅游

 

因为已经发现高海拔地区的先天性心脏病发生率明显高于平原地区，可能与缺氧有关。

 

6、必要的检查

 

母体在怀孕中期可进行胎儿心脏彩超，检查胎儿的心脏是否正常。


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心脏病患者如何保护心脏呢？很多朋友对于一些护心方法并不了解，今天找良医网带你学习5个能保护心脏的方法，一起来学习吧！

\"专家向您解答

 

1.不做过于剧烈的运动

经常做过于剧烈的运动可损害人的心脏，尤其易引起心房纤颤。这里说的剧烈运动就是指“能出一身大汗的运动”。与不进行剧烈运动的人相比，每周进行5～7次剧烈运动的人出现心房纤颤的几率可增加20%左右。与此相反，人们若是每周做5次轻运动（使人出现轻度气喘的运动），每次运动30分钟，可使自己患心脏病和中风的几率降低35%～50%，并可提高体内好胆固醇的水平。

 

2.熟知自己的体重指数、血压、血脂和血糖水平

人们只有对自己的体重指数、血压、血脂和血糖水平了然于心，才能有效地防范和应对心脏病。

 

3.及时缓解压力

人们若经常处于生活压力过大、情绪抑郁的状态中，会出现血糖水平升高、腹部脂肪堆积、体重增加、甘油三酯水平升高等症状，而且发生血管栓塞和心脏病的几率就会显著增高。

 

4.经常冥想打坐

若每天冥想打坐2次，每次冥想打坐30分钟，连续做此项运动7个月就可减少血管内壁脂肪堆积的情况。此外，冥想打坐能降低人体内血清素和肾上腺素等应激激素的水平，取得降血压的效果。

 

5.不打断别人的话

抢着说话可使人的血压升高、心率加快。与善于倾听的人相比，经常打断别人说话的人，其患心脏病的几率可增高47%左右。

 

看这4个地方了解自己是否有心脏病

 

一、皮肤

慢性心力衰竭、晚期肺源性心脏病患者的皮肤可呈深褐色或暗紫色，这与机体组织长期缺氧，肾上腺皮质功能下降有关，也是常见的心脏病的早期症状。皮肤粘膜和肢端呈青紫色，说明心脏缺氧，血液中的还原血蛋白增多。

 

二、脸色

如果脸色灰白而发紫、表情淡漠，这同样属于心脏病的早期症状。如果脸色呈暗红色，这是风湿性心脏病、二尖瓣狭窄的特征。如果呈苍白色，则有可能是二尖瓣关闭不全的征象。

 

三、鼻子

如果鼻子硬梆梆的，这表明心脏脂肪累积太多。如果鼻子尖发肿，表明心脏脂肪可能也在肿大或心脏病变正在扩大。此外，红鼻子也常预示心脏有病。这是常见的心脏病的早期症状。

 

四、呼吸

作了一些轻微活动时，或者处于安静状态时，出现呼吸短促现象，但不伴咳嗽，咳痰。这种情况很可能是左心功能不全的表现。

 

找良医网温馨提示：如有身体不适，请及时就医！


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先心病是一种常见的心血管疾病，多发于新生儿，那么婴儿患有先心病应该如何护理呢？今天就跟着找良医网一起了解一下患有先心病如何护理比较好！

\"专家向您解答

 

1、应为患儿安排合理的生活制度，既要增强锻炼、提高机体的抵抗力，又要适当休息，避免劳累过度。如果患儿能够胜任，应尽量和正常儿童一起生活和学习，但应防止剧烈活动。同时，应教育儿童对治疗疾病抱有信心，减少悲观恐惧心理。

 

2、室内空气要流通。冬天应定时打开窗户，以加强空气对流。有持续青紫的患儿，应避免室内温度过高，导致患儿出汗、脱水。

 

3、给予高蛋白、高热量、富含维生素的饮食，以增强体质。进食避免过饱。对青紫型心脏病患儿须给以足够的饮水量，以免脱水而导致血栓形成。有先天性心脏病的婴儿，喂养比较困难，吸奶时往往易气促乏力而停止吮吸，且易呕吐和大量出汗，故喂奶时可用滴管滴入，以减轻患儿体力消耗。喂哺后轻轻放下侧卧，以防呕吐物吸入而吸起窒息。

 

4、避免患儿情绪激动，尽量不使患儿哭闹，减少不必要的刺激，以免加重心脏负担。

 

5、保持大便通畅。对青紫型患儿注意大便时勿太用力，以免加重心脏负担。如两天无大便，可用开塞露通便。

 

6、先天性心脏病患儿禁止大量输液，如必须输液时，滴液速度须缓慢，以防加重心脏负担，导致心力衰竭。7、法乐氏四联症的患儿多取蹲踞位，在行走或玩耍时常会主动蹲下片刻。这是因为蹲踞后可使缺氧症状得到缓解，患儿如有这种现象，家长切不可强行将患儿拉起。

 

7、对平时心脏功能和活动耐力都较好的患儿，应当按当时接受预防接种，但在接种后，应多观察全身和局部反应，以便及时处理。

 

8、先天性心脏病的患儿体质弱，易感染疾病，尤以呼吸道疾病为多见，且易并发心力衰竭，故应仔细护理，随着季节的变换，及进增减衣服。如家庭成员中有上呼道感染时，应采取隔离措施，平时应尽量少带患儿去公共场所，在传染病好发季节，尤应及早采取预防措施。一旦患儿出现感染时，应积极控制感染。

 

9、如发现患儿有气急烦躁、心率过快、呼吸困难等症状，可能发生心力衰竭，应及时送医院就诊。

 

找良医网温馨提示：如有身体不适，请及时就医！


","barId":"1869","topicTypeId":"3","topicThemeId":"1036","readLevel":1,"files":"[]","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1240,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1510033633065,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1510033633065,"metaSearch":null,"rn":0,"barTitle":null,"checkcode":null,"forumUser":{"id":"8abb11d0af1511e7a3d800163e04584d","isDel":0,"createAt":1507789271266,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"良药苦口","password":"zx13401068656","level":0,"nickName":"周良药","realName":null,"signName":"良药苦口利于病，忠言逆耳利于行！","head":"http://01luntan.com/ly_img/1516263139285.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"langlixunta@163.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110114","userLevel":0,"modifyNameCount":1},"lyTopicReply":null,"createAtStr":null,"lyBar":null,"lyTopic":null},{"id":"7089","isDel":0,"createAt":1510033410760,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":1525770537638,"updateBy":"8abb11d0af1511e7a3d800163e04584d","updateName":"良药苦口","userId":"8abb11d0af1511e7a3d800163e04584d","title":"专家向您解答 养心护心学会这8个方法","content":"

心脏是支撑着人体健康运行的器官，夏季是个适合养心护心的季节，那么在夏季我们应该如何保护心脏呢？找良医网在本文中为您解答！

\"专家向您解答 

   

1、每周吃3次鱼

提倡多吃鱼并不仅仅是因为鱼油中的ω-3脂肪酸有益于心脏和动脉，大量的动物研究显示，鱼肉中的蛋白亦对心血管健康具有重要的作用。如果你不喜欢海鲜类，那么每天食用30克核桃同样可以为身体提供ω-3脂肪酸。

 

2、减少生活压力

慢性压力不仅影响到睡眠，而且还不益于心血管健康，因此学会给自己减压至关重要。

 

3、每天散步半小时

哈佛大学的一项研究显示，人的一生中每多锻炼一个小时，将会使寿命增加两个小时。每天有规律地锻炼有助于心脏的泵血功能和抗衰老。

 

4、了解自己的血压

高血压是心脑血管疾病的罪魁祸首。我们通常认为血压保持在120/80mmHg至130/85mmHg的范围就已属正常了。事实上，如果能够把血压从130/85mmHg降至115/76mmHg，就意味着自己的身体年轻了10岁。目前没有数据显示服用药物降压可以达到使人年轻的效果。现在还是推荐锻炼、减少体重和减轻压力，而且体育活动的益处往往是立竿见影的。

 

5、每天至少睡7个小时

睡眠过少可引起代谢变化进而增加肥胖和糖尿病风险，这两种情况下的心脏病患病风险也会随之增加。最近芝加哥大学的一项研究也显示，成人每晚睡眠时间过少，将会导致动脉内钙沉着增加。

 

6、控制感染

慢性感染可增加刺激机体对抗出血进而导致心脏病发作风险增加。慢性口腔感染性疾病也是导致心血管疾病发生的危险因素之一。

 

7、避免接触二手烟

不要让其他人在你的房间吸烟，被动吸烟1小时相当于吸2~4支烟。

 

8、每天服用小剂量阿司匹林

最近几年的大量研究显示低剂量的阿司匹林有助于预防女性心脏病和癌症，但是最具说服力的证明是阿司匹林可降低卒中的发生。40岁以上的中老年人，推荐每天服用150毫克，在服药前后各饮用半杯水，以减少药物对胃的刺激。

 

找良医网温馨提示：如有身体不适，请及时就医！


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夏季天气闷热，急性心梗、心绞痛等心脏病患者明显增多。所以先天性心脏病患者平时的日常生活和饮食都需要特别的注意，那么先天性心脏病患者夏季防暑降温要怎么做呢？

\"专家向您解答

  

心脏病与高血压，糖尿病以及一些血管疾病有关。夏季气温升高，与夏季的一些饮食、休息等生活习惯会影响心脏病的发生和发展。

 

1、夏季饮食要清淡，做菜的时候不要放过多调料，少吃盐，少吃糖，少吃油腻的食物，预防高血脂高血压的发展，对心脏病的预防也有帮助。

 

2、夏天人体循环和代谢也会比较快，心脏的负担会加重，容易出现缺氧心率加快。气温变化，血压容易上升，导致诱发心脏病。

 

3、夏季天气闷热，急性心梗、心绞痛等心脏病患者明显增多。冠心病是中老年人的常见病和多发病，而且一般有多年高血压或糖尿病史。夏季也预防高血压，糖尿病的发展。

 

4 、心脏病患者在夏天要注意防暑降温，避免中暑，保证充足的睡眠，饮食规律，保持心情舒畅，中老年患者平时可以适当做些运动，比如散步，慢跑等。

 

先天性心脏病夏季护理措施

 

1、制定适合患儿活动量的生活制度

根据患儿的病情不同区别对待。轻型无症状者应与正常儿童一样生活；有症状患儿应限制活动，避免情绪激动和剧哭，以免加重心脏负担；重型患儿应卧床休息，给予妥善的生活照顾。

 

2、 预防感染

向患儿及家长介绍自我保护，防止感染的知识，应避免与感染性疾病患者接触。病室要空气新鲜，穿着衣服冷热要适中，防止受凉。一旦发生感染应积极治疗。

 

3、供给营养需要

给予高蛋白、高热量、高维生素饮食，以增强体质。适当限制食盐摄入，还要给予适量的蔬菜类粗纤维食品，以保证大便通畅，重型患儿喂养困难，应特别细心、耐心、少食多餐，以免导致呛咳、气促、呼吸困难等，必要时从静脉补充营养。

 

4、观察病情变化，防止并发症发生

（l）注意心率、心律、脉搏、呼吸、血压及心杂音变化，必要时使用监护仪监测。

（2）防止法洛氏四联症患儿因哭闹、进食、活动排便等引起缺氧发作，一旦发生可立即置于膝胸卧位，吸氧，通知医师，并做好普萘洛尔、吗啡应用和纠正酸中毒等准备。

（3）青紫型先天性心脏病患儿，由于血液粘稠度高，暑天、发热、多汗、吐泻时体液量减少，加重血液浓缩，易形成血栓，造成重要器官栓塞的危险，因此应注意多饮水、必要时静脉输液。

（4）合并贫血者，可加重缺氧，导致心力衰竭，须及时纠正，饮食中宜补充含铁丰富的食物。

 

5、做好心理护理

关心患儿，建立良好护患关系，充分理解家长及患儿对检查、治疗、预后的期望心情，介绍疾病的有关知识、诊疗计划、检查过程、病室环境，消除恐惧心理，说服家长和患儿主动配合各项检查和治疗，使诊疗工作顺利进行。

 

6、健康教育

指导患儿及家长根据病情建立合理的生活制度和活动量，维持营养，增强抵抗力，防止各种感染，掌握观察病情变化的知识。行扁桃体摘除术与拔牙时，给足量的抗生素。防止发生感染性心内膜炎。心功能较好者可按时预防接种。定期到医院就诊检查，使患儿能安全达到适合手术的年龄。

 

找良医网温馨提示：如有身体不适，请及时就医！


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先天性心脏病是一种特别常见的疾病，要想尽快摆脱这类疾病，做好的方法就是手术。要想治愈先天性心脏病，唯一的途径就是进行心脏手术。那么做完心脏手术后怎么护理？是很多人关心的问题。

 \"专家向您解答 

   

先天性心脏病术后护理要点：

 

1、不要抓挠刀口

要保持刀口局部干燥，避免摩擦、抓挠等，拆线后伤口上有干痂，不要用力剥除，也不要用水浸泡，待其自然脱落，痂下皮肤就能愈合。刀口局部及周围可能有疼痛、不适，甚至同侧肩关节活动不方便，这些都是正常术后反应，随着时间增长会逐渐恢复。

 

2、避免感冒

术后头两周，孩子在接触外人时应戴上口罩。有些孩子爱活动，平时多汗，家长应给孩子勤换内衣，出汗的内衣贴在身上时间过长就会感冒。出院头两周，家长应密切观察孩子的体温和症状，每天测一次体温，如体温超过38℃，千万不能随意服退烧药，应立即去医院就诊，在医生指导下进行治疗。

 

3、术后定期复查

出院3个月后应到医院复诊，一年后要全面复查，以让医生了解心功能恢复情况。术后1～3个月内，家长要注意观察孩子的身体状况，如有医嘱，定时服药，注意吃喝的量与尿量要平衡，体重不能增加太快，如有不适，及时去医院就诊。

 

先天性心脏病是孩子在出生时就携带的一种疾病，引起先天性心脏病的原因有很多的，最常见的就是准妈妈在怀孕的时候收到风寒等刺激而引发病毒感染所导致的，先天性心脏病需要及时医治，医生建议最佳的治疗时间是1--5岁，这时候小儿的体质较强，降低了手术的风险。

 

4、术后护理

呼吸机的配合，心脏手术病人一般都要上呼吸机，麻醉清醒后，病人会感到咽部不舒服，不能讲话，病人需主动配合。头部切勿过多转动，不要随意吞咽，尤其是婴幼儿呼吸道粘膜反复磨擦可引起声门出血，对于不配合的小儿，可给予镇静剂。拔除气插管后的配合，病情平稳脱离呼吸机，用面罩或鼻导管继续吸氧。此时病人应保持安静。术后有效咯痰时病人是预防肺内感染或肺不张等并发症的重要环节，应积极配合。

 

5、家庭护理

尽量让孩子保持安静，避免过分哭闹，保证充足的睡眠。大些的孩子生活要有规律，动静结合，既不能在外边到处乱跑，也不必整天躺在床上，晚上睡眠一定要保证，以减轻心脏负担。心功能不全的孩子往往出汗较多，需保持皮肤清洁，夏天勤洗澡，冬天用热毛巾擦身，勤换衣裤。多喂水，以保证足够的水份。居室内保持空气流通，患儿尽量避免到人多拥挤的公共场所逗留，以减少呼吸道感染的机会。应随天气冷暖及时增减衣服，密切注意预防感冒。

 

找良医网温馨提示：如有身体不适，请及时就医！


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大家也应该都听说过先天性心脏病这种疾病，很多宝宝在没有出生之前就会被诊断出患上了这种疾病，近些年来这种疾病的发病几率也在逐年的增高，导致宝宝患上这种疾病，主要是因为孕妇怀孕期间受到病毒的入侵所导致的，那么宝宝在进行手术之后，家长应该要如何做好先天性心脏病护理工作呢？找良医网帮您详细解答！

  

\"如何做好先天性心脏病的护理工作\"


(1) 术后心血管系统护理：临床上根据患儿正常的动静脉血气分析指标、温暖的四肢末梢、正常的尿量，可以推定患儿有合适的心排量。

  

(2) 术后呼吸系统护理：心脏术后受多因素影响引起呼吸功能障碍导致术后病程延长，增加住院费用和治疗护理上的难度。常用的监测方法包括耳垂、四肢末梢动脉血氧饱和度，X线胸片，以及呼吸机应用时的潮气量、气道阻力等监测。

  

(3) 术后肺部护理：小儿呼吸系统有其特有的生理特点，术后容易发生肺部感染、肺不张等并发症而导致肺功能不全，影响心功能恢复。定时翻身、变化体位、拍背、雾化吸入等都是有效预防肺部并发症的护理。

  

(4) 术后神经系统护理：体外循环手术后有时会并发脑部弥漫性或局限性损伤，其严重程度可呈可逆性或器质性损害，是术后严重并发症之一。

  

(5) 术后消化系统护理：先心病术后因受麻醉、体外循环、镇静、肌松药物、应急反应等影响，患儿的消化系统可有不同程度障碍，以腹泻最为常见，饮食结构调整、忌油腻食物、调节肠道菌群药物运用等都是有效的护理措施。  


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      先心病的发生率在活产新生儿中为4‰～50‰, 许多学者在不同的领域开展了对环境因素包括生物、化学、物理、社会心理诸方面的研究, 其中有关环境中的危险因素对人类出生缺陷的影响引起了公众和科学界的关注。妊娠早期是胎儿心脏发育的关键时期, 环境中致畸原的存在增加了先心病, 尤其是某种类型先心病发生的风险。


        由于商用和家用除莠剂的使用, 使得环境中这类化学品普遍存在, 某些化合物, 由于其高脂溶性和抗分解性, 如ddt, 在人体和环境中可持续存在许多年, 在人乳和脂肪组织中可检测到有机氯杀虫剂和其他稳定的有机氯化合物。目前已在许多美国人的脂肪组织中检测到一定水平的除莠剂化合物。


        妊娠早期暴露于任何种类的杀虫剂, 均增加了婴儿出现大动脉转位的危险; 暴露于除莠剂、灭鼠剂发生大动脉转位的危险增加2-3倍。研究表明, 大动脉转位可能是妊娠早期与环境杀虫剂暴露有关的唯一的心血管畸形。


       大多数有大动脉转位的婴儿合并有多种心脏畸形47%伴有单纯室间隔缺损, 且75%以上生活在空气中释放有毒化学物质和存在有害废物场所为特征的两个地区。发生在这两个地区的病例发病风险增加13倍。妊娠第2个月暴露于一氧化碳与发生室间隔缺损的危险与污染物浓度呈剂量- 效应关系。妊娠第2个月暴露于臭氧, 增加了发生主动脉弓及瓣膜缺陷、肺动脉缺陷及瓣膜异常、共同动脉干缺陷的危险。而车辆是这些地区空气污染的主要来源, 污染物的主要成份是一氧化碳、二氧化氮、空气动力学直径小于10 um的颗粒物质和臭氧。高比例的一氧化碳、二氧化氮和气动力学直径小于10 um的颗粒物质, 在城市的逆温层堆积, 尤其是在寒冷季节。臭氧是产生在对流层继发于二氧化碳和碳氢化合物的污染物, 并以同季节相反的方式发生作用。在冬季, 高浓度的一氧化碳与平均风速有关, 风速影响着一氧化碳的发散, 低温度减少垂直层混合并引起近表层的逆温层更强, 持续更久, 在夏季由于阳光而产生高水平的臭氧。空气污染导致先心病的机制是空气污染可通过血液动力学、缺氧过程、氧化应激反应和毒素等环节影响胎儿发育过程中的一定细胞群, 与出生缺陷的病因学有关。


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   如果遇到家族中有先心病患者、妈妈怀孕早期有呼吸道感染、怀孕期间得糖尿病、饮酒、受到放射线照射、孕期服药不当等情况，应高度重视和警惕。糖尿病、癫痫等病的患者应在医生的指导下决定结婚和怀孕时间；妈妈在怀孕前应当适当增加营养，加强体育锻炼，以增强抵抗疾病的能力；爸爸妈妈在怀孕前都应戒烟戒酒；长期接触放射线或接受放射线治疗的妈妈要在脱离放射线至少半年后再怀孕。妈妈怀孕期间应避免接触各种农药、化学药物，不用含激素的化妆品，身体不舒服，应该到医院检查，在医生的指导下治疗用药。 
　　一定要把好三道关： 
　　怀孕期间按时进行孕期检查是非常有好处的。首先，医生会叫你避免一些容易导致胎儿不健康的不利影响；其次，可以掌握胎儿的发育情况，一旦遇到发育异常，可以采取适当的手段终止怀孕。有研究表明，在怀孕期间补充叶酸对部分“先心病”有预防作用。 
　　曾有统计，我国先天性心血管病的发病率约为7－10‰，每年约有15～20万出生婴儿患有先天性心脏病。预防“先心病”的关键在孕期，准父母在决定要宝宝的那一天起，就应承担起责任和义务，避免“心”的悲剧发生，确实要守好三道关。 
　　一道关就是在孕前和怀孕早期，要预防感冒，少接触电脑，加强营养，慎重用药，减少先天性心脏病的发生率。 
　　二道关就是在胎儿期及时做一些检查，如果发现胎儿是先天性心脏病，可以考虑终止怀孕。 
　　三道关是手术，一般在孩子出生后，发现孩子有以下表现之一者，就要考虑孩子是否有“先心病”，应及时到相关医院去检查：(1)喂养困难或婴儿拒食，发育迟缓，呼吸急促，哭闹及吃奶后口唇青紫；(2)平时容易得感冒及肺炎，疲乏，出汗，发育较同龄儿差；(3)运动能力差，稍一活动就会出现心慌气短；(4)胸前心脏位置的前区隆起；(5)出现晕厥、水肿等。 
　　随着科技的发展，现在大部分“先心病”都可以通过手术治疗，成功率比较高，手术成功的孩子可以康复，和正常孩子一样学习和生活。


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  1. 适龄婚育

  2. 　　医学已经证明，35岁以上的孕妇发生胎儿基因异常的风险明显增加。因此最好在35岁以前生育。如果无法做到这一点，那么建议高龄孕妇必须接受严格的围产期医学观察与保健。

　　2.准备要孩子前要做好心理、生理状态的调节

　　如果准妈妈有吸烟、饮酒等习惯，最好至少在怀孕前半年就要停止。

　　3.加强对孕妇的保健

　　特别是在妊娠早期积极预防风疹、流感等风疹病毒性疾病。孕妇应尽量避免服用药物，如必须使用，必须在医生指导下进行。

　　4.孕期避免去高海拔地区旅游

　　因为已经发现高海拔地区的先天性心脏病发生率明显高于平原地区，可能与缺氧有关。


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　　1.准妈妈在孕早期要积极预防风疹、流行性感冒，腮腺炎等病毒感染。避免接触放射线及一些有害物质。在医生指导下用药，避免服用对胎儿发育有影响的药物。 

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　　2.准妈妈要戒掉不良嗜好，在孕期不吸烟，不饮酒。 

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　　3.在怀孕早期尽量不要在电脑前、微波炉旁等磁场强的地方坐太长时间，因这时的胎儿还不稳定，各个器官还正在成形阶段，很可能造成宝宝先天性心脏病。 

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　　4.不要接触宠物。因宠物身上的细菌及微生物也可能对宝宝有伤害。 

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　　5.避免将心脏病遗传给孩子。如果本身有心脏病，要想全面了解先天性心脏病对结婚及生育的影响，也可以到心脏病专科去做检查，如做心脏B超，根据自己心脏病的类型，听一听医生的建议，进行遗传咨询。 

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一、研究对象 
　　病例组：2012年7月1日至2013年6月30日，在湖北省45家出生缺陷监测医院内出生并确诊为CHD的孕满28周至产后7天围产儿的母亲。共调查133例，有效问卷125份。 
　　对照组：与CHD患儿来源于同一家医院，出生年月相差不超过1个月的正常围产儿母亲。两组按照年龄相差不超过2岁，居住地相同（同一个县或区），以1∶2比例进行匹配。共调查246例，有效问卷235份。 
　　两组年龄、职业、民族、常住地差异无统计学意义（P>0.05），而受教育程度差异有统计学意义（χ2=10.37，P=0.006）。 
　　1.1工具 
　　1.1.1 自编问卷调查表 
　　包括一般人口学资料和围产儿基本资料。 
　　1.1.2 症状自评量表(SCL-90)［2］ 
　　产后1周内对研究对象进行孕早期（妊娠前3个月）心理健康状况的回顾性调查。每个项目均采用1（无）至5（严重）级评分。 
　　1.2 统计方法 
　　进行t检验，χ2检验和logistic 回归分析。 
　　 
二、结 果 
　　2.1 心理问题检出情况 
　　以SCL-90任何一项因子分≥2分为心理问题阳性［3］，结果病例组心理问题总体阳性率、抑郁和恐怖因子阳性率均高于对照组，见表1。 
　　 
　　2.2 孕早期心理健康状况与发生先天性心脏病的关系 
　　以胎儿是否患CHD为应变量(1=是，0=否)，以孕早期是否存在心理问题及SCL-90各因子是否阳性为自变量（≥2为阳性=1，�2为阴性=0），进行logistic 回归分析。结果显示：以孕妇年龄、民族、受教育程度、职业、常住地、孕次、孕前和孕早期患病为控制变量，心理问题阳性者，其胎儿患CHD的风险是正常心理状态者的2.16倍；恐怖因子阳性者，其胎儿患CHD的风险增加（OR=3.23）（见表2）。 
　　 
三、讨 论 
　　本研究结果显示病例组心理问题总体阳性率、抑郁和恐怖因子阳性率均高于对照组，提示与正常围产儿母亲相比，CHD患儿母亲孕早期可能存在较多心理健康问题。但由于调查时间是在产后1周内，两组结果的差异可能受到病例组情绪不佳这一混杂因素的影响，结果有待进一步验证。logistic 回归分析结果显示：在控制孕妇年龄、民族、受教育程度、职业、常住地、孕次、孕前和孕早期患病等因素的影响后，孕早期有心理问题者，将增加其胎儿患CHD的危险性（OR=2.16），说明孕早期心理异常可能是胎儿CHD的危险因素之一。

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