早发型重度子痫前期期待疗法的影响因素探讨

Factors associated with expectant management in early onset severe pre-eclampsia

目的 探讨早发型重度子痫前期期待疗法终止的影响因素. 方法回顾性分析2003年1月～2009年6月本院收治的104例早发型重度子痫前期患者,按入院后治疗时间分为期待疗法组和积极治疗组,期待疗法组治疗时间48 h～27 d,积极治疗组治疗时间≤48 h,观察期待疗法终止的影响因素. 结果 70.2%（73/104）患者入选期待疗法,29.8%（31/104）患者接受积极治疗;期待疗法组的收缩压、舒张压、谷草转氨酶、肌酐及尿素氮平均水平低于积极治疗组（P〈0.05）;期待疗法过程中因社会因素和胎儿宫内窘迫放弃期待疗法者分别占35.6%（26/73）和19.2%（14/73）;期待疗法组围生儿死亡率为19.2%（14/73）,无孕产妇死亡. 结论大多数早发型重度子痫前期患者可实施期待疗法,社会因素和胎儿宫内窘迫是期待疗法终止的最常见因素.

Objective To explore factors associated with expectant management in early onset severe pre - eclampsia. Methods Retrospective analysis of 104 patients with early onset severe pre - ec- lampsia admitted to a tertiary hospital from Jan 2003 to Jun 2009 was performed. Patients were divided into two groups： the expectant management group and the aggressive management group. Factors associated with expectant management were amalyzed. Results Of the 104 patients, 73 （70. 2 % ） were managed ex- pectantly and 31 （29. 8 % ） delivered after stabilization and evaluation. The mean values of systolic blood pressure, diastolic blood pressure, aspartate aminotransferase, serum creatininc and serum urea nitrogen in the expectant management group were lower than those in the aggressive management group （ all Ps 〈 O. 05 ）. In the expectant management group, 26 cases gave up expectant management for social reasons and 14 cases for fetal distress. Perinatal mortality rate was 19. 2 % （ 14/73 ）. No maternal mortality was found. Con- clttsion Majority of the women with early onset pre - eclampsia were qualified for expectant management. Social factors and early fetal distress were the most frequent reasons for patients to stop expectant manage- ment.