不同类型早发型重度子痫前期患者期待治疗时间及妊娠结局的比较

Comparison of expectant treatment time and pregnancy outcome with different types of early onset severe preeclampsia

目的：探讨单纯早发型重度子痫前期（SPE）患者与慢性高血压并发早发型SPE患者的期待治疗时间及妊娠结局的差异。方法：选取2011年6月1日~2014年2月30日于石家庄市第四医院产科诊治并分娩的单胎早发型SPE孕妇350例,其中慢性高血压并发早发型SPE患者60例（A）组,单纯早发型SPE患者290例（B组）。比较两组孕妇的期待治疗时间及母儿结局。结果：慢性高血压并发早发型SPE患者的最高收缩压和舒张压及胎儿生长受限发生率均明显高于单纯早发型SPE患者,期待治疗时间明显长于单纯早发型SPE患者,低蛋白血症及肺水肿发生率低于单纯早发型SPE患者,差异均有统计学意义（P〈0.05）。两组孕妇的胎盘早剥、HELLP综合征和子痫等发生率、围产儿死亡率、新生儿死亡、胎死宫内、新生儿窒息的发生率比较,差异无统计学意义（P〉0.05）。结论：慢性高血压并发早发型SPE患者较单纯早发型SPE的期待治疗时间长,在病情允许的情况下,通过严密监测母儿一般状况,可适当延长孕周,降低围产儿死亡率。

Objective：To explore the expectant treatment time and pregnancy outcome between early-onset （SPE）superimposed on chronic hypertension and isolated early-onset （SPE）. Methods ：Totally 350 singleton pregnant women with early- onset（SPE） who were trea- ted in The fourth hospital of Shijiazhuang City from June. 2011 to Feb. 2014 were identified and divided into two groups：early- onset（ SPE ）superimposed on chronic hypertension （group A, n= 60） and isolated early-onset （SPE） （group B, n = 290 ）. The expectant treatment time and pregnancy outcome of all subjects were collected and analyzed. Results： The highest systolic blood pressure, diastolic blood pressure and the incidence of fetal growth restriction in group A were significantly higher than those in group B. The expectant treatment time of A group was longer than that of B group, The incidence of the low proteinemia and pulmonary edema of A group was lower than that of B group, the difference was statistically significant （P〈0.05）. The incidence of placental abruption, HELLP syndrome, eclampsia, neonatal asphyxia, intrauterine death, perinatal mortality, and neonatal mortality rate showed no difference between the two groups （ P〉0.05 ）. Conclusions ： The expectant treatment time of early-onset （ SPE ） superim- posed on chronic hypertension was longer than that of isolated early-onset （SPE）. In the case of the disease allowed, monitoring to the mothers and fetuses, Taking appropriate expectant man- agement can postpone week of gestation.