妊娠期高血压急症的临床分析

Clinical analysis of hypertensive emergency in pregnancy

目的：研究妊娠期高血压急症的临床特点和结局。方法；分析我科2000年1月～2005年3月收治15例高血压急症（急症组）的年龄、孕周及延长的孕周，与同期收治的子痫前期（对照组）64例孕妇比较。结果：急症组与对照组孕妇年龄中位数分别为28岁和27．5岁（P〉0．05），孕周中位数分别为30周和38周（P〈0．001），延长孕周中位数分别为4天和1天（P〈0．001）。两组的并发症分别为60．00％和15．62％（P〈0．001）。急症组蛋白尿与血压之间无相关性。结论：妊娠期高血压急症发病时间早，孕周小，妊娠年龄偏大，并发症多而重。不能单凭蛋白尿来预测高血压急症的发生。降压时应考虑对胎儿和各脏器血液灌注量的影响，及时终止妊娠，以剖宫产为宜。

Objective： To study the Clinical characteristics and results of hypertensive emergency in pregnancy. Methods： From Jan, 2000 to Mar, 2005, the age, gestational age and prolonged gestational age of 15 cases with hypertensive emergency in pregnancy in our department （ emergency group） were analyzed, and compared with 64 cases with preeclampsia （ control group ） . Results： In emergency group and control group, the median age were 28 and 27. 5 years old respectively （ P 〉 0. 05 ）, median gestational age were 30 and 38 weeks respectively （ P 〈 0. 001 ）, medianprolonged gestational age were 4 days and 1 day respectively （ P 〈 0. 001 ） . The complications were 60% and 15.62% respectively （ P 〈 0. 001 ） . There were no relationship between urine protein and tension in Emergency group. The value of urine protein only conldn＇t predict the incidence of hypertensive Emergency. Conclusion： Onset of hypertensive emergency in pregnancy is early during small gestational weeks, with older conceptive age and more severe complications. Influence of fetus and organ blood perfusion should be considered during acute blood- pressure lowering, pregnancy should be terminated in time. Cesarean delivery is preferred.