重度子痫前期视网膜病变与母儿预后的临床分析

Clinical Analysis of the Relationship between Retinopathy at Severe eclampsia and Prognosis of Mother and Infant

目的探讨视网膜病变的发生及严重程度与高血压、蛋白尿、病程严重程度及围产儿预后的关系,为重度子痫前期处理提供重要依据。方法对我院1993年1月～2007年7月住院的重度子痫前期患者458例进行常规眼底检查。结果458例重度子痫前期患者中发现视网膜病变312例,发生率为68.12%,其中I期198例,占63.46%;Ⅱ期96例,占30.77%;Ⅲ期18例,占5.77%。在发生视网膜病变312例患者中,胎盘早剥48例,心功能衰竭29例,产后出血85例,死亡0例。新生儿轻度窒息44例,占9.61%;重度窒息率11例,占2.40%;新生儿死亡6例,占1.3%。胎儿生长受限(FGR)58例,占12.67%。结论视网膜病变的发生及严重程度与高血压、蛋白尿、病程严重及围产儿预后均有密切关系,对临床医师适时终止妊娠,判断孕产妇及围产儿预后,及时采取相应的措施,改善母儿预后有一定帮助。

Objective To discuss the relationship between retinopathy and hypertension, proteinuria, disease course and prognosis of mother and infant. Methods 458 patients with severe preeclarnpsia were examined normal fundus check. Results Among 458 cases,patients with retinopathy were 312 cases（68.12%）,cases at stage I were 198 cases（63.46%）,stage Ⅱ 46 cases（14.74%）,stage Ⅲ 68 cases（21.79%）. A- mong 312 cases with retinopathy, placenta abruption 48 cases,heart failure 29 cases, postpartum hemorrhage 85 cases,no death. Neonatal mild asphyxia 44 cases（9.61%）, severe asphyxia 11 cases（2.40% ）, dead 6 cases（ 1.3% ）. Conclusion The occurrence and severity of retinopathy is related with hypertension, proteinuria, disease course and prognosis of infant and is helpful to judge the prognosis of mother and infant and take relevant measures and improve the prognosis of mother and infant.