摘要
目的根据妊娠期生理变化与重度子痫前期及子痫的病理特点,建立客观量化的病情严重程度评估系统。方法回顾性分析1999年10月至2007年10月转入广州医科大学附属第三医院(广州重症孕产妇救治中心)产科重症监护病房的437例重度子痫前期及子痫患者病历资料进行病情严重程度量化评分,分析分值与重度子痫前期或子痫患者各器官功能障碍及并发症的关系,建立重度子痫前期及子痫患者病情严重程度评估系统。不同评分组间器官功能障碍采用x2检验分析,重度子痫前期及子痫患者病情评估系统死亡风险预测公式采用logistic回归分析。结果建立的重度子痫前期及子痫评分系统由20个生理参数组成,包括:体温、血压、呼吸频率、心率、氧分压、氧合指数(PaO2/FiO2)、pH值、钠离子浓度、钾离子浓度、肌酐、丙氨酸氨基转移酶、血小板计数、总胆红素、白蛋白、纤维蛋白原、白细胞计数、血细胞比容、血尿酸、年龄及神经系统评分。随着评分分值增加,重度子痫前期和子痫患者器官功能障碍发生率及器官受损数目显著增加。死亡风险预测公式:log eY/(1-Y)=-6.56+0.927×神经系统评分+0.149×(总评分-神经系统评分)。结论初步建立了重度子痫前期及子痫病情严重程度评估系统,以利于提高该类患者病情评估。
Objective To establish a prediction system for preeclampsia and eclampsia patients according to pregnancy physiological and pathological changes. Methods A retrospective study was conducted in 437 preeclampsia and eclampsia patients, who were admitted to the intensive care unit of the Third Affiliated Hospital of Guangzhou Medical University from October 1999 to March 2007. Then we analyzed the relationship between scores and the maternal organ dysfunction, and established the prediction scoring system for preeclampsia and eclampsia. The data were analyzed by using Chi-square test and the mortality prediction equation by using logistic regression model. Results The prediction system involved 20 clinical indexes, including body temperature, pressure, respiratory rate, heart rate, arterial partial pressure of oxygen, PaO2/FiO2 , arterial pH value, serum sodium, serum potassium, serum creatinine, ALT, blood platelets count, serum total bilirubin, serum albumin, fibrinogen, white blood count, hematocrit, blood uric acid, age and scores of nervous system. The number of organ dysfunction was increaring with the scores up. The prediction equation for the mortality risk was log eY/( 1 - Y) = -6. 56 + 0. 927 × scores of nervous system + 0. 149 × ( total scores - scores of nervous system). Conclusion Establishing a prediction system for the preeclampsia and eclampsia patients can evaluate the illness severity better.
出处
《中华产科急救电子杂志》
2013年第3期37-42,共6页
Chinese Journal of Obstetric Emergency(Electronic Edition)
关键词
先兆子痫
疾病严重程度指数
预测
病情评估
Pre-eclampsia
Severity of illness index
Forecasting
Evaluating severity