CAJ | 학술논문

目的：探讨期待治疗对不同孕周的早发型重度子痫前期孕妇及其产儿结局的影响。方法：选取本院2012年2月-2013年11月收治的146例早发型重度子痫的怀孕患者，按照孕周及重度子痫前期分类标准将其分为A组45例、B组49例和C组52例。根据临床情况进行期待治疗，并观察和记录三组的期待治疗时间、孕妇并发症、孕妇结局以及围生儿情况。结果：A组和C组的期待治疗时间均明显少于B组（P<0.05）。三组并发症发生率比较结果：A组>B组>C组，比较差异均有统计学意义（P<0.05）；三组孕妇中C组的顺产率最高，相互比较差异均有统计学意义（P<0.05）。三组围生儿中A组的体重最轻，C组最高，相互比较差异均有统计学意义（P<0.05）；围生儿的死亡率A组>B组>C组，比较差异均有统计学意义（P<0.05）；此外，对围生儿的Apgar评分结果显示，A组<B组<C组，比较差异均有统计学意义（P<0.05）。结论：孕周<28周者，保守的期待治疗难以达到改善围生结局的目的，孕周在28~31周者，应采用积极有效的期待治疗，适当地延长孕周；孕33周左右的胎儿可考虑终止妊娠而减少孕妇并发症的发生。
목적：탐토기대치료대불동잉주적조발형중도자간전기잉부급기산인결국적영향。방법：선취본원2012년2월-2013년11월수치적146례조발형중도자간적부잉환자，안조잉주급중도자간전기분류표준장기분위A조45례、B조49례화C조52례。근거림상정황진행기대치료，병관찰화기록삼조적기대치료시간、잉부병발증、잉부결국이급위생인정황。결과：A조화C조적기대치료시간균명현소우B조（P<0.05）。삼조병발증발생솔비교결과：A조>B조>C조，비교차이균유통계학의의（P<0.05）；삼조잉부중C조적순산솔최고，상호비교차이균유통계학의의（P<0.05）。삼조위생인중A조적체중최경，C조최고，상호비교차이균유통계학의의（P<0.05）；위생인적사망솔A조>B조>C조，비교차이균유통계학의의（P<0.05）；차외，대위생인적Apgar평분결과현시，A조<B조<C조，비교차이균유통계학의의（P<0.05）。결론：잉주<28주자，보수적기대치료난이체도개선위생결국적목적，잉주재28~31주자，응채용적겁유효적기대치료，괄당지연장잉주；잉33주좌우적태인가고필종지임신이감소잉부병발증적발생。
Objective:To explore the effect of expectant treatment on early onset severe preeclampsia mother-child outcomes with different gestational age.Method:A total of 146 pregnant woman with early onset severe preeclampsia who were treated with expectant treatment in our hospital from February to November 2013 were selected,according to gestational weeks and severe preeclampsia classification standard,they were divided into 45 cases in group A,49 cases in group B and 52 cases in group C.Expectant treatment time,pregnant complications,pregnant outcome and perinatal infants of three groups were observed and recorded.Result:Expectant treatment time of group A and group C were significantly less than group B(P<0.05).The complication rate in group A was higher than that of group B,and the group B was higher than that of group C,the differences were statistically significant (P<0.05).The birth rate of the group C was the highest,and the differences in the three groups were statistically significant(P<0.05).The children weight of the group A was the lightest,and that of the group C was the heaviest,and the differences in the three groups were statistically significant(P<0.05). The children death rate of group A was higher than that of group B,and the group B was higher than that of group C,and the differences in the three groups were statistically significant(P<0.05).The Apgar scores of group A was lower than that of the group B,and that of the group B was lower than that of the group C,and the differences in the three groups were statistically significant(P<0.05).Conclusion:The expectant treatment used in patients with gestational age<28 weeks is difficult to achieve the purpose of improving perinatal outcomes.Patients with gestational age from 28 to 31 weeks should be adopted a positive and effective treatment expectations and lengthen gestational weeks properly.If patients’ gestational age is about 33 weeks,the patient can consider pregnancy termination for reducing the incidence of maternal complications.