妊娠期高血压疾病合并脑血管疾病的临床观察

Clinical observation on hypertensive disorder complicating pregnancy combined with cerebrovascular disease

目的:探讨妊娠期高血压合并脑血管疾病的发病原因、预防措施以及治疗方案。方法:回顾性分析该院2003～2008年收治的487例妊娠期高血压疾病合并脑血管疾病的临床资料。结果:2003～2008年共收治妊娠期高血压疾病患者2 416例,其中合并脑血管疾病487例(20.16%),包括蛛网膜下腔出血23例,脑出血58例和脑梗死406例。临床症状包括头痛、眩晕、嗜睡、视物模糊、意识障碍、呕吐、抽搐以及肢体感觉或轻度运动障碍;头颅CT或MRI检查后可确诊;及时终止妊娠,解痉降压治疗后,1例产妇死亡,3例胎儿死亡。结论:妊娠时期,积极预防妊娠期高血压疾病,定期监测脑血管的血流情况。合并脑血管疾病时候,应及时行头颅CT检查或MRI确诊,适时终止妊娠,积极治疗,尽量保障母婴的生命安全。

Objective：To explore the causes,preventive measures and therapeutic schedule of hypertensive disorder complicating pregnancy（HDCP） combined with cerebrovascular disease. Methods：The clinical data of 487 cases with HDCP combined with cerebrovascular disease who were treated in the hospital from 2003 to 2008 were analyzed retrospectively. Results：2 416 patients with HDCP were treated in the hospital from 2003 to 2008,and 487 patients were combined with cerebrovascular disease（20.16%）,including 23 patients with subarachnoid hemorrhage,58 patients with cerebral hemorrhage and 406 patients with cerebral infarction.The clinical symptoms included headache,dizziness,somnolence,blurred vision,disturbance of consciousness,vomiting,hyperspasmia,limb sensory disturbance or mild dyskinesia;the diagnosis was confirmed by CT or MRI;after termination of pregnancy timely,spasmolysis and depressurization,one pregnant woman and three fetuses died. Conclusion：HDCP should be prevented actively during pregnancy,and cerebrovascular blood flow should be monitored regularly.For patients with HDCP combined with cerebrovascular disease,timely cerebral CT and MRI should be carried out for definite diagnosis,terminating pregnancy timely and active treatment are important to ensure the safety of mothers and their infants.