摘要
目的探讨分析子痫前期(PE)患者合并胎盘早剥(PA)的相关危险因素,为其临床预防提供参考依据。方法选取2017年9月~2018年9月我院产科收治的246例PE患者作为研究对象,根据其是否合并胎盘早剥分为胎盘早剥组(n=52)和非胎盘早剥组(n=194)。收集两组患者的病例资料,对合并胎盘早剥患者的相关危险因素进行单因素分析和多因素Logistic回归分析。结果单因素分析结果显示,胎盘早剥组患者的孕龄、既往分娩史、舒张压、纤维蛋白原、血清清蛋白、尿素氮、血肌酐、24 h尿蛋白量、孕早期阴道出血史以及羊水过少等情况与非胎盘早剥组比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,既往分娩史(β=0.368,OR=1.672,95%CI 1.148~2.965,P=0.032)、纤维蛋白原(β=0.416,OR=1.637,95%CI 1.164~2.691,P=0.025)、血肌酐(β=0.195,OR=1.166,95%CI 1.015~1.987,P=0.013)以及24 h尿蛋白量(β=0.228,OR=1.583,95%CI 1.183~2.592,P=0.018)均是PE患者合并PA的危险因素。结论PE患者合并PA的病理机制较为复杂,纤维蛋白原水平过低、24 h尿蛋白量、血肌酐水平过高以及多次分娩史是PE患者合并PA的危险因素,因此,针对这些高危人群应加强干预,提前做好预防,以改善产妇的妊娠结局。
Objective To study the risk factors of preeclampsia(PE)combined with placental abruption(PA),and to provide reference for clinical prevention.Methods From September 2017 to September 2018,246 patients with PE treated in Obstetrics department of our hospital were selected as the subjects,and divided into placental abruption group(n=52)and non-placental abruption group(n=194)according to whether they were complicated with placental abruption or not.Case data of the two groups were collected,and the risk factors associated with the placental abruption were analyzed by single factor analysis and multi-factor Logistic regression analysis.Results The results of univariate analysis showed that there were significant differences in gestational age,previous delivery history,diastolic blood pressure,fibrinogen,serum albumin,urea nitrogen,serum creatinine,24 h urinary protein,vaginal bleeding history and oligoamniotic fluid between the placental abruption group and the non-placental abruption group(P<0.05).The results of multivariate Logistic regression analysis showed that the past delivery history(β=0.368,OR=1.672,95%CI 1.148-2.965,P=0.032),fibrinogen(β=0.416,OR=1.637,95%CI 1.164-2.691,P=0.025),serum creatinine(β=0.195,OR=1.166,95%CI 1.015-1.987,P=0.013)and 24 h urinary protein content(β=0.228,OR=1.583,95%CI 1.183-2.592,P=0.018)were the risk factors of placental abruption in patients with preeclampsia.Conclusion The pathological mechanism of PE patients with PA is complicated,the level of fibrinogen is too low,the amniotic fluid is too low,the 24 h urine protein amount and the level of blood creatinine is too high,and the history of multiple delivery are the risk factors of PE patients with PA.Therefore,the intervention should be strengthened and prevention should be taken in advance in order to improve the pregnancy outcome of pregnant women.
作者
吴晓爽
文英
WU Xiao-shuang;WEN Ying(The Fifth-ward of Obstetrics,Dalian Maternal and Child Health Hospital and Dalian Maternal and Obstetric Hospital Maternal,Liaoning Province,Dalian 116600,China;Department of Obstetrics,Dalian Maternal and Child Health Hospital and Delivery Room of Dalian Maternal and Obstetric Hospital,Liaoning Province,Dalian 116600,China)
出处
《中国当代医药》
2019年第34期92-94,共3页
China Modern Medicine
