摘要
目的探讨影响早发型重度子痫前期患者期待治疗成功的因素及有效治疗措施。方法对我院收治的128例重度子痫前期患者的诊断治疗及妊娠结局、孕产妇并发症进行回顾性分析,其中界定为早发型重度子痫前期患者有56例。根据其发生的孕周不同分为A组（20~27＋6周）、B组（28~31＋6周）、C组（32~33＋6周）、D组（34~周）,根据保守治疗孕周延长时间分为Ⅰ组（4~7 d）、Ⅱ组（8~20 d）、Ⅲ组（〉20 d）。主要分析指标有发病孕周、终止妊娠孕周、孕周延长时间、严重并发症发生情况及妊娠结局。结果 （1）新生儿及胎儿死亡率：A、B、C、D组分别为91.7%、36.0%、5.3%、1.4%,差异有统计学意义（P〈0.01）;胎儿生长受限发生率：A、B、C、D组分别为50.0%、12.0%、10.5%、1.4%,差异有统计学意义（P〈0.01）。保守治疗时间：A、B、C、D组分别为（12±3）d、（14±4）d、（15±3）d、（5±4）d,A、B、C 3组间差异无统计学意义（P〉0.05）,D组与前3组比较差异有统计学意义（P〈0.01）。（2）A、B、C、D 4组孕产妇并发症的发生率分别为58.3%、48.0%、47.4%、34.7%,差异无统计学意义（P〉0.05）。（3）Ⅰ、Ⅱ、Ⅲ组孕产妇并发症的发生率分别为17.9%、73.5%、87.5%,差异有统计学意义（P〈0.05）。结论对早发型重度子痫前期保守治疗应拟定个体化治疗方案,根据自身医疗机构的早产儿抢救监护水平及对孕妇病情进行评估,准确地选择终止妊娠的时机及方案是保守治疗能否成功的决定因素。
Objective To investigate the factors that influence the success of conservative treatment of severe early onset preeclampsia and the effective treatment measures.Methods Totally 56 patients with severe early onset preeclampsia were enrolled in this study.According to their gestational ages,they were divided into group A（20 ~ 27＋6W）,group B（28 ~ 31＋6W）,group C（32 ~ 33＋6W）,and group D（34W）.According to the extended gestational age by conservative treatment,these patients were also divided into 3 groups：group I（extended by 4 ~7 days）,group II（by 8 ~ 20 days）,and group III（by 20 days）.Main indicators included gestational age of disease onset,gestational age of pregnancy termination,extended gestational age,serious complications,and outcomes of pregancy.Results The mortality rate of neonates and fetuses was 91.7% in group A,36.0% in group B,5.3% in group C,and 1.4% in group D（P〈0.01）.The fetal growth restriction（FGR） rate was 50.0% in group A,12.0% in group B,10.5% in group C,and 1.4% in group D（P〈0.01）.The duration of conservative treatment was（12±3） days in group A,（14±4） days in group B,（15±3） days in group C,and（5±4） days in group D（P〉0.05 among groups A,B,and C;P〈0.05 between group D and the other three groups）.The incidence of complications was 58.3% in group A,48.0% in group B,47.4% in group C,and 34.7% in group D（P〈0.05）.The incidence of maternal complications was 17.9% in group I,73.5% in group II,and 87.5% in group II（P〈0.05）.Conclusion The conservative treatment of severe early onset preeclampsia should be customized.Factors that may influence the success of conservative treatment include the rescue capability,appropriate evaluation of disease,and the timing and protocol of pregnancy termination.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第36期4104-4107,共4页
Chinese General Practice
关键词
早发型重度子痫前期
保守治疗
妊娠结局
Early onset severe preeclampsia
Conservative treatment
Pregnancy outcome
