CAJ | 학술논문

目的：探讨妊娠期高血压疾病患者的终止妊娠时机及分娩方式对妊娠结局的影响。方法选取本院产科于2011年11月-2013年10月收治的妊娠期高血压疾病孕妇156例，根据终止妊娠时机分为3组：A 组（＜34周，22例）、B 组（34～36周，41例）、C 组（＞36周，93例）；根据分娩方式分为2组：经阴道分娩组（38例）和剖宫产组（118例）。分别对比不同妊娠时机、不同分娩方式新生儿出生体质量、新生儿窒息发生率、新生儿死亡率以及产妇并发症发生率。结果 A 组新生儿出生体质量显著低于 B、C 组（P ＜0．01），B 组显著低于 C 组（P ＜0．01）；A 组新生儿窒息发生率及新生儿死亡率显著高于 B、C 组（P ＜0．01或 P ＜0．05），B 组显著高于 C 组（P ＜0．05）。不同终止妊娠时机产妇并发症发生率比较差异无统计学意义（P ＞0．05）。经阴道分娩组新生儿出生体质量显著低于剖宫产组（P ＜0．01）；而经阴道分娩组新生儿窒息发生率、死亡率以及产妇并发症发生率均显著高于剖宫产组（P ＜0．01）。结论孕周较小的妊娠期高血压疾病患者应给予合理的治疗以适当延长妊娠时间，于妊娠36周左右时终止妊娠，并应尽可能选择剖宫产，从而降低经阴道分娩对产妇及胎儿造成的伤害，降低新生儿及产妇围生期并发症发生率。
목적：탐토임신기고혈압질병환자적종지임신시궤급분면방식대임신결국적영향。방법선취본원산과우2011년11월-2013년10월수치적임신기고혈압질병잉부156례，근거종지임신시궤분위3조：A 조（＜34주，22례）、B 조（34～36주，41례）、C 조（＞36주，93례）；근거분면방식분위2조：경음도분면조（38례）화부궁산조（118례）。분별대비불동임신시궤、불동분면방식신생인출생체질량、신생인질식발생솔、신생인사망솔이급산부병발증발생솔。결과 A 조신생인출생체질량현저저우 B、C 조（P ＜0．01），B 조현저저우 C 조（P ＜0．01）；A 조신생인질식발생솔급신생인사망솔현저고우 B、C 조（P ＜0．01혹 P ＜0．05），B 조현저고우 C 조（P ＜0．05）。불동종지임신시궤산부병발증발생솔비교차이무통계학의의（P ＞0．05）。경음도분면조신생인출생체질량현저저우부궁산조（P ＜0．01）；이경음도분면조신생인질식발생솔、사망솔이급산부병발증발생솔균현저고우부궁산조（P ＜0．01）。결론잉주교소적임신기고혈압질병환자응급여합리적치료이괄당연장임신시간，우임신36주좌우시종지임신，병응진가능선택부궁산，종이강저경음도분면대산부급태인조성적상해，강저신생인급산부위생기병발증발생솔。
Objective To discuss the clinical influence of time of termination of pregnancy and method of delivery for pregnancy outcomes in pregnant patients with hypertension.Methods 156 pregnant patients with hypertension were divided into less than 34 weeks group with 22 pa-tients,34-36 weeks group with 41 patients,over 36 weeks group with 93 patients according to the time of the termination of pregnancy,and two groups including vaginal delivery group with 38 patients and cesarean section group with 118 patients according to delivery methods.The birth weight,neonatal asphyxia,neonatal mortality,maternal morbidity were contrasted between the three and two groups.Results The birth weight in the less than 34 weeks group were signifi-cantly lower than that the 34-36 weeks group and above 36 weeks group (P <0.01).The 34-36 weeks group was significantly lower than that in the above 36 weeks group(P <0.01).Neona-tal asphyxia and neonatal mortality in the less than 34 weeks group were significantly higher than that in the 34-36 weeks group and above 36 weeks group(P <0.01 or P <0.05).The 34-36 weeks group was significantly higher than that in the above 36 weeks group(P <0.05).But the difference was not significant in maternal morbidity in the three groups (P > 0 .0 5 ).The birth weight in the vaginal delivery group were significantly lower than that in the cesarean section group(P <0.01).And the neonatal asphyxia,neonatal mortality,and maternal morbidity in the vaginal delivery group were significantly higher than that in the cesarean section group (P <0.01).Conclusion Pregnancy patients with hypertension in shorter gestational time should be given reasonable treatment to extend pregnancy time.And they should terminate pregnancy at about 36 weeks of pregnancy and operate cesarean section to reduce the damage to the fetal.In this way,neonatal and maternal perinatal morbidity can reduce.