妊娠期高血压疾病与妊娠结局的相关性

Correlative analysis between hypertensive disorder complicating pregnancy and birth outcomes

目的：分析妊娠期高血压疾病发病的高危因素以及孕期保健与并发症之间、治疗方案选择与妊娠结局的关系，探讨降低妊娠期高血压疾病的发生率、减少并发症的措施，从而改善母婴结局。方法：回顾性分析我院2004年7月～2006年6月妊娠期高血压疾病患者587例，分析其高危因素、孕期产检情况与并发症发生的比例，妊高征治疗方案选择与妊娠结局的关系。结果：妊娠期高血压疾病高危因素多为肥胖、高龄、精神紧张、双胎、营养差者；并发症的发生率与产检次数成反比，产检越正规、次数越多，并发症发生机会越少，正规产检与不正规产检及从不产检者并发症发生率分别为22．82％、37．41％、63．38％，三者比较P〈0．01，差异有显著性；妊娠期高血压疾病实施规范治疗方案与否与早产、低出生体重儿、新生儿窒息、早期新生儿死亡、子痫、心衰、胎盘早剥，差异有显著性。结论：大力宣传孕产期保健知识，加强流动人口管理，提倡正规产检，严格执行妊高征处理规范及三级转诊制度，可减少妊娠期高血压疾病及其并发症，改善母婴结局。

Objective： To investigate the measure of cutting down the incidence rate of hypertensive disorders in pregnancy and reducing complication to improve the outcome by analyzing the relation between the high risk of hypertensive disorders in pregnancy, health care duration of pregnancy and the occurrence of complication, the choice of therapeutic regimen, the end - results of pregnancy. Methods： 587 cases with hypertensive disorders in pregnancy in this hospital during July 2004 to June 2006 were retrospective analyzed, and to compare the high factors, the ratio of the state of examination during pregnancy and the occurrence of complication, the relation between the choice of therapeutic regimen and the outcome of pregnancy. Results： High risk factors of hypertensive disorder complicating pregnancy inelude fatness, advanced age, nervous mentality, multiple pregnancy and dystrophia. The incidence of complications rose inversely with prenatal visit times, more regular prenatal visit and more frequency, less incidence of complications. The incidence of complications in pregnant woman with regular prenatal visit or not was 22. 82%, 41. 94%, respectively. The incidence was 63. 38% among those without prenatal visit at all （P 〈0. 01 ）. There were different pregnancy outcome at premature birth, low birth weight infant, neonatal asphyxia, early neonatal death, eclamptism, congestive heart failure, placental abruption whether to practice the standard therapeutic regimen of hypertensive disorders in pregnancy. Conclusion： The knowledge of pregnant health protection should be publicized broadly to intensify the management of floating population. Meanwhile, regular prenatal visit should be conducted to carry out standardized treatment. It is essential to perform three -level patient transferring system strictly. It is helpful to decrease the incidence of hypertensive disorder complicating pregnancy and complications. It is helpful to improve maternal -fetal prognosis.