257例重度子痫前期／子痫降压药应用现状分析

A study on application of antihypertensive drugs on 257 cases with severe preeclampsia and eclampsia

目的探讨重度子痫前期／子痫降压药的应用情况，针对存在的问题提出改进措施。方法收集孕产妇死亡率较高的河南省某县2005年7月-2007年8月所有开展助产技术服务的医疗保健机构中重度子痫前期／子瘸住院病例，对其病历资料进行调查研究，制定降压药规范化应用基本标准，评价其服务质量，分析降压药应用与妊娠结局的关系。结果257例中仅有49．42％达到降压药规范化应用基本标准。规范化应用降压药的病例其胎盘早剥发生率（2．61％）乖低出生体重儿的比例（17．17％）显著低于未规范化应用者（9．24％、36．54％），经比较差异有统计学意义（X^2值分别为4．577和9．631，均P〈o．05）。结论该地区医务人员在规范化应用降压药治疗重度子痫前期／子痫病例中存在明显不足，服务质量有待进一步提高，以促进母婴健康。

Objective To explore the application status of antihypertensive drugs on 257 cases with severe preeclampsia and eclampsia in order to propose targeted improvements. Methods This study was conducted from July 2005 to August 2007. Medical data of pregnant patients with severe preeclampsia and eclampsia were collected from all of the hospitals where midwifery services were carried out in some county of Henan Province where the maternal mortality rate was high. The data were analyzed, and basic criterion on standard application of antihypertensive drugs was developed for evaluating its service quality. In addition, the relationship between application of antihypertensive drugs and pregnancy outcomes was explored. Results Only 127 （49.42%） of 257 cases achieved the basic standard on antihypertensive application. The incidence of placental abruption （2.61%） and the proportion of low birth weight infants （ 17.17% ） of cases with standard application of antihypertensive agents were obviously lower than those （9.24%, 36.54% ） of cases without standard application respectively, and the differences were statistically significant （X2 was 4.577 and 9.631 respectively, P 〈 O. 05 ）. Conclusion In the study area there is obviously deficiency on standard application of antihypertensive drugs on severe preeclampsia and eclampsia. Quality of service should be further improved in order to promote maternal and child health.