重度子痫前期并发胸腹腔积液临床分析

Clinical analysis for 30 cases of severe preeclampsia complicated by hydrothorax and ascites

目的探讨重度子痫前期并发胸腹腔积液的临床特点和救治方法。方法回顾性分析2006年1月至2010年6月重度子痫前期并发胸腹腔积液患者30例的临床资料。患者均有不同程度的高血压、低蛋白血症表现,合并中等量胸腔积液,多表现为胸闷、呼吸困难和血氧饱和度下降;合并腹腔积液者多有腹胀,部分合并肺水肿、心力衰竭、肾衰竭。结果治疗后,胸腹腔积液于术后5～12d内逐渐消失,无一例产妇死亡。共分娩34例新生儿,死亡10例,其余近期预后良好。结论重度子痫前期并发胸腹腔积液严重威胁母儿安全,应加强产前保健,及早发现并进行对症支持治疗,适时终止妊娠,避免不可逆转的病情和严重的并发症,改善妊娠结局。

Objective To investigate the clinical features and therapy for severe preeclampsia complicated by hydrothorax and ascites. Methods The clinical data of 30 patients with severe preeclampsia complicated by hydrothorax and ascites admitted in our hospital from January 2006 to June 2010 were retrospectively analyzed. The patients suffered from different degrees of hypertension, hypoproteinemia, complicating by moderate dose of hydrothorax, and the patients showed that dyspnea and the decrease of blood oxygen saturation, and the patients with hydrothorax had abdominal distension, furthermore, part of patients had complications including pulmonary edema,heart failure and renal failure. Results After treatment, the hydrothorax and ascites were dribble away, without death case. The total 34 neonates were delivered of whom 10 neonates died, but the others were well developed in the near future. Conclusion The severe preeclampsia complicated by hydrothorax and ascites threatens seriously the security of mother and fetus, so the prenatal care should be strengthened in order to detect disease early and to give symptomatic and supportive treatment. The timely termination of pregnancy can avoid the occurrence of irreversible disease and severe complications and can improve pregnancy outcome.