中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
10期
1103-1107
,共5页
杨华光%李艳红%李怡%尹国武
楊華光%李豔紅%李怡%尹國武
양화광%리염홍%리이%윤국무
重度早发型子痫前期%妊娠并发症%期待疗法%妊娠结局
重度早髮型子癇前期%妊娠併髮癥%期待療法%妊娠結跼
중도조발형자간전기%임신병발증%기대요법%임신결국
Early onset severe preeclampsia%Pregnancy complications%Expectant treatment%Pregnancy outcomes
目的 从妊娠结局探讨早发型重度子痫前期患者剖宫产术后的安全性及手术效果.方法 回顾分析236例孕龄为28 ～ 33+6周重度子痫前期患者的完整临床资料(实验组),并将399例孕龄在34周以上的重度子痫前期患者作为对照组.主要分析指标包括:发病孕龄、终止妊娠孕龄、孕龄延长时间、终止妊娠的方式、严重并发症发生情况、围产儿病死率和新生儿窒息率.结果 实验组保守治疗时间为(13.5±1.2)d,对照组为(9.6±1.0)d,两组比较差异有统计学意义(t =3.760,P ＜0.001).剖宫产率实验组为70.8％ (167/236);对照组71.2％ (284/399),两组组比较差异无统计学意义(x2=0.012,P=0.911).两组胎死宫内发生率比较,差异无统计学意义(2.5％与2.8％,x2=0.026,P=0.871),但新生儿中重度窒息率(25.8％与10.8％,x2=20.792,P＜0.001)及围产儿病死率(22.0％与6.9％,x2=27.782,P＜0.001)比较,差异均有统计学意义.结论 对于重度早发型子痫前期患者,在保证母亲安全的基础上采取适当的保守期待疗法,既可以避免或减少孕产妇严重并发症发生的可能性,又能适当延长孕龄,降低围产儿患病率和病死率,终止妊娠的方式以剖宫产为宜.
目的 從妊娠結跼探討早髮型重度子癇前期患者剖宮產術後的安全性及手術效果.方法 迴顧分析236例孕齡為28 ～ 33+6週重度子癇前期患者的完整臨床資料(實驗組),併將399例孕齡在34週以上的重度子癇前期患者作為對照組.主要分析指標包括:髮病孕齡、終止妊娠孕齡、孕齡延長時間、終止妊娠的方式、嚴重併髮癥髮生情況、圍產兒病死率和新生兒窒息率.結果 實驗組保守治療時間為(13.5±1.2)d,對照組為(9.6±1.0)d,兩組比較差異有統計學意義(t =3.760,P ＜0.001).剖宮產率實驗組為70.8％ (167/236);對照組71.2％ (284/399),兩組組比較差異無統計學意義(x2=0.012,P=0.911).兩組胎死宮內髮生率比較,差異無統計學意義(2.5％與2.8％,x2=0.026,P=0.871),但新生兒中重度窒息率(25.8％與10.8％,x2=20.792,P＜0.001)及圍產兒病死率(22.0％與6.9％,x2=27.782,P＜0.001)比較,差異均有統計學意義.結論 對于重度早髮型子癇前期患者,在保證母親安全的基礎上採取適噹的保守期待療法,既可以避免或減少孕產婦嚴重併髮癥髮生的可能性,又能適噹延長孕齡,降低圍產兒患病率和病死率,終止妊娠的方式以剖宮產為宜.
목적 종임신결국탐토조발형중도자간전기환자부궁산술후적안전성급수술효과.방법 회고분석236례잉령위28 ～ 33+6주중도자간전기환자적완정림상자료(실험조),병장399례잉령재34주이상적중도자간전기환자작위대조조.주요분석지표포괄:발병잉령、종지임신잉령、잉령연장시간、종지임신적방식、엄중병발증발생정황、위산인병사솔화신생인질식솔.결과 실험조보수치료시간위(13.5±1.2)d,대조조위(9.6±1.0)d,량조비교차이유통계학의의(t =3.760,P ＜0.001).부궁산솔실험조위70.8％ (167/236);대조조71.2％ (284/399),량조조비교차이무통계학의의(x2=0.012,P=0.911).량조태사궁내발생솔비교,차이무통계학의의(2.5％여2.8％,x2=0.026,P=0.871),단신생인중중도질식솔(25.8％여10.8％,x2=20.792,P＜0.001)급위산인병사솔(22.0％여6.9％,x2=27.782,P＜0.001)비교,차이균유통계학의의.결론 대우중도조발형자간전기환자,재보증모친안전적기출상채취괄당적보수기대요법,기가이피면혹감소잉산부엄중병발증발생적가능성,우능괄당연장잉령,강저위산인환병솔화병사솔,종지임신적방식이부궁산위의.
Objective To discuss the safety and operation effect of cesarean sectionof patients with early onset severe preeclampsia.Methods Clinical data were retrospectively analyzed,the treatment group made up of 236 patients with severe preeclampsia whose gestational age from 28 to 33 +6 weeks and the control group with 399 pregnancy women above 34 weeks.Main analytical items included:onset of gestational age,gestational age of termination of pregnancy,protensive of gestation,methods of termination of pregnancy,status of the occurrence of serious complications,fetal and neonatal mortality and the rate of neonatal asphyxia.Results The average conservative treatment time of treatment group was was significantly longer than that of control group [ ( 13.5 ± 1.2) d vs (9.6 ± 1.0 ) d,t =3.760,P ＜ 0.001].There was no significant difference on the cesarean section rate[70.8％ (167/236) vs 71.2％ (284/399),x2 =0.012,P =0.911 ] and neonatal mortality(2.5％vs 2.8 ％,x2 =0.026,P =0.871 ) between these two gourps.However there was significant difference on the rate of neonatal asphyxia(25.8％ vs 10.8％,x2 =20.792,P ＜ 0.001 ) and perinatal mortalit (22.0％ vs 6.9％,x2=27.782,P ＜ 0.001 ) between these two groups.Conclusion For the patients with severe early onset preeclampsia,to take conservative expectant treatment appropriately based on the safety of motherhood could avoid or reduce the possibility of the occurrence of serious complications,could extend the gestational age appropriately as well as reduce fetal and neonatal prevalence and mortality.Cesarean section is proper for the termination of pregnancy.
