重度子痫前期并发胎盘早剥的临床观察

Clinical observation on severe preeclampsia combined with placental abruption

目的：探讨重度子痫前期并发胎盘早剥的临床特征及妊娠结局。方法：对深圳市光明新区人民医院2010—2012年收治85例重度子痫前期患者10例合并胎盘早剥为观察组，75例未合并胎盘早剥为对照组。结果：两组患者在年龄、体重指数、发病孕周、产次、产前最高收缩压对比差异无统计学意义（P〉0．05）；观察组患者在产前最高舒张压、24h尿蛋白定量、血清白蛋白、重度水肿、产前阴道流血、眼底小动脉出血、胎儿窘迫均高于对照组，差异有统计学意义（P〈0．05）；新生儿窒息、新生儿死亡、产后出血、DIC、胎盘卒中、子宫切除均高于对照组，差异有统计学意义（P〈0．05）。结论：胎盘早剥是重度子痫前期患者严重的并发症，在治疗早期应重视患者临床表现，同时监测病情变化，结合B超检查对患者早诊断、早治疗，可以有效提高母婴预后。

Objective： To explore the clinical characteristics and pregnancy outcome of severe preeclampsia combined with placental abruption. Methods： Eighty -five patients with severe preeclampsia treated in the hospital from 2010 to 2012 were selected and divided into observation group （including 10 patients combining with placental abruption） and control group （including 75 patients only with severe preeclampsia） . Results ：There was no statistically significant difference in age, body mass index, the onset gestational week, parity and prenatal peak systolic pressure between the two groups （ P 〉 0. 05 ） ; the prenatal diastolic blood pressure, 24 - hour urinary protein, serum albumin, severe edema, prenatal vaginal bleeding, retinal arteriolar bleeding and fetal distress in observation group were statistically significantly higher than those in control group （ P 〈 0. 05 ） ; the incidence rates of neonatal asphyxia, neonatal death, postpartum hemorrhage, DIC, placental apoplexy and hysterectomy in observation group were statistically significantly higher than those in control group （ P 〈 0. 05 ）. Conclusion ： Placental abruption is a serious complication of severe preeclampsia, in the early stage of treatment, more attention should be paid to clinical manifestations of the patients, while the condition changes should be monitored, combining with type B ultrasound examination, early diagnosis and early treatment can effectively improve maternal and infantile prognosis.