CAJ | 학술논문

目的：探讨孕期定期产检对早发型重度子痫前期（ EOSP）母儿结局的影响。方法回顾分析2000年6月至2013年6月于兰溪市妇幼保健院妇产科门诊建卡产检、住院治疗并分娩的146例EOSP患者的临床资料，依据孕期是否定期产检分为未定期产检的对照组（97例）与定期产检的观察组（49例），比较两组孕产妇的一般资料与并发症发生情况以及围生儿结局。结果对照组中初产妇占57．73％，明显低于观察组的85．71％（χ2＝11．551，P＜0．05）；对照组有子痫前期病史者占4．12％，明显低于观察组的16．33％（χ2＝6．426，P＜0．05）；对照组患者的最高收缩压、舒张压平均值为（178．32±23．75） mmHg和（120．73±13．34）mmHg，分别明显高于观察组患者的（165．84±18．32）mmHg与（112．35±10．79）mmHg，（t值分别为3．223、3．810，均P＜0．05）。首发异常表现观察组多为尿蛋白（＋）或尿蛋白（＋＋）合并血压值升高，而对照组多为血压升高或血压升高合并神经系统症状。两组孕产妇严重并发症发生率及两组围生儿的胎儿窘迫发生率、新生儿出生体重、Apgar评分、新生儿窒息发生率比较差异均无统计学意义（均P＞0．05）。对照组围产儿死亡率为37．11％，明显高于观察组的18．37％（χ2＝5．366，P＜0．05）。结论孕产妇孕期定期产检对早期发现EOSP有积极意义，早期发现的患者多可通过有效干预控制病情，为行期待疗法争取更多的时间，从而降低了围产儿死亡率。
목적：탐토잉기정기산검대조발형중도자간전기（ EOSP）모인결국적영향。방법회고분석2000년6월지2013년6월우란계시부유보건원부산과문진건잡산검、주원치료병분면적146례EOSP환자적림상자료，의거잉기시부정기산검분위미정기산검적대조조（97례）여정기산검적관찰조（49례），비교량조잉산부적일반자료여병발증발생정황이급위생인결국。결과대조조중초산부점57．73％，명현저우관찰조적85．71％（χ2＝11．551，P＜0．05）；대조조유자간전기병사자점4．12％，명현저우관찰조적16．33％（χ2＝6．426，P＜0．05）；대조조환자적최고수축압、서장압평균치위（178．32±23．75） mmHg화（120．73±13．34）mmHg，분별명현고우관찰조환자적（165．84±18．32）mmHg여（112．35±10．79）mmHg，（t치분별위3．223、3．810，균P＜0．05）。수발이상표현관찰조다위뇨단백（＋）혹뇨단백（＋＋）합병혈압치승고，이대조조다위혈압승고혹혈압승고합병신경계통증상。량조잉산부엄중병발증발생솔급량조위생인적태인군박발생솔、신생인출생체중、Apgar평분、신생인질식발생솔비교차이균무통계학의의（균P＞0．05）。대조조위산인사망솔위37．11％，명현고우관찰조적18．37％（χ2＝5．366，P＜0．05）。결론잉산부잉기정기산검대조기발현EOSP유적겁의의，조기발현적환자다가통과유효간예공제병정，위행기대요법쟁취경다적시간，종이강저료위산인사망솔。
Objective To explore the influence of regular antenatal examination during pregnancy on outcomes of perinatal infant and pregnant woman with early onset severe pre-eclampsia ( EOSP) .Methods A retrospective analysis was conducted on the clinical data of 146 cases of EOSP who set up card, hospitalized and gave birth in Lanxi City Maternal and Child Health Hospital during the period of June 2000 to June 2013.The cases were divided into control group without regular antenatal examination (97 cases) and observation group with regular antenatal examination (49 cases) .The general data, complications and perinatal outcomes of two groups were compared.Results In the control group primiparas accounted for 57.73%, which was significantly lower than that in the observation group (85.71%) (χ2 =11.551,P<0.05), and the cases with history of preeclampsia occupied 4.12%, which was significantly lower than the observation group (16.33%) (χ2 =6.426,P<0.05).In the control group the highest systolic blood pressure and the average diastolic pressure were 178.32 ±23.75mmHg and 120.73 ±13.34mmHg, respectively, which were significantly higher than those in the observation group (165.84 ±18.32 mmHg, 112.35 ±10.79 mmHg) (t value was 3.223 and 3.810, respectively, both P<0.05).Urinary protein(+) or urinary protein (++) with blood pressure increase were the major first abnormalities observed in the observation group, while in the control group elevated blood pressure or high blood pressure complicated with nervous system symptoms were the major abnormalities.There were no significant differences in the incidence of severe complications and perinatal fetal distress, neonatal birth weight, Apgar score and neonatal asphyxia incidence between two groups (all P>0.05).The perinatal mortality of the control group was 37.11%, which was significantly higher than that of the observation group (18.37%) (χ2 =5.366,P<0.05).Conclusion Regular prenatal examination has positive significance for early detection of EOSP.Patients detected early can control the disease through effective interventions for gaining more time for expectant treatment, and thereby to reduce perinatal mortality.