妊娠期高血压疾病及并发症与母婴结局的关系

The relationship among hypertensive disorder complicating pregnancy and its complications and outcomes of mother and baby

目的通过回顾广西靖边县人民医院258例妊娠期高血压疾病孕妇的临床资料，探讨妊娠期高血压疾病及其并发症与母婴结局的关系。方法对258例妊娠期高血压疾病孕妇的病例资料（病例组）与同期分娩的258例正常孕妇（正常组）的临床资料进行对比分析。结果病例组并发症中低蛋白血症发生率为8．14％、胎盘早剥为2．33％、早产为67．83％、产后出血为12．02％、胎儿窘迫为48．45％、生长受限为61．63％、低体重儿为53．49％、新生儿窒息为51．55％，与正常组比较差异均有统计学意义（χ^2值分别为10．37、4．22、116．11、13．12、81．19、157．00、121．90、106．40，均P〈0．05）。病例组围产儿死亡发生率与正常组比较差异无统计学意义（P〉0．05）。病例组剖宫产率（81．01％）比正常组（34．88％）明显增高，阴道分娩率（18．99％）比正常组（65．12％）明显降低（χ^2=112．62，P〈0．05）。产后1个月复查发现，病例组产后高血压遗留发生率（19．38％）明显高于正常组（0），差异有统计学意义（χ^2=55．36，P〈0．05）。结论妊娠期高血压疾病与母婴关系密切，且并发症严重。合理有效预防、及早治疗都可有效改善或降低母婴不良并发症的发生率。

Objective To discuss the rela^tionship among hypertensive disorder complicating pregnancy （HDCP） and its complications and the outcomes of mother and baby by retrospective analysis of the clinical data of 258 cases of hypertensive disorder complicating pregnancy in PeQple＇ s Hospital of Jingxi. Methods The clinical data of 258 cases of HDCP （ case group） were compared to those of 258 normal pregnant women delivering at the same period （ control group）. Results The incidence rates of hypoproteinemia, placental abruption, premature birth, postpartum hemorrhage, fetal distress, growth restriction, low birth weight and neonatal suffocation in case group were 8.14%, 2.33%, 67.83%, 12.02%, 48.45%, 61.63%, 53.49% and 51.55%, respectively, and they were significantly different from those in control group （χ^2 value was 10.37, 4.22, 116.11, 13.12, 81.19, 157.00, 121.90 and 106： 40, respectively, all P 〈 0.05 ）. There was no significant difference in perinatal death between two groups （ P 〉 0.05 ）. The cesarean section rate of case group （81.01% ） was significantly higher than that of control group （34.88 % ）, and the vaginal delivery rate （ 18.99% ） was significantly lower than that of control group （65.12%） （χ^2 = 112.62, P 〈 0.05）. Recheck after one month indicated that the incidence of hypertension of case group （19.38%） was obviously higher than that of control group （0）, and the difference was significant （χ^2 =55.36,P 〈0. 05）. Conclusion HDCP has close relationship with mother and baby, and the complications are serious. Reasonable and effective prevention and early treatment can effectively improve outcomes or reduce the incidence of perinatal adverse complications.