重度妊娠高血压合并血小板减少综合征患者应用地塞米松的临床疗效分析

Severe pregnancy induced hypertension complicated with analysis of the reduced platelet syndrome patients using dexamethasone

目的探讨地塞米松对重度妊娠高血压合并血小板减少综合征患者的临床的疗效。方法选取我院在2011-2014年期间收治的48例重度妊娠高血压合并血小板减少综合征患者设为实验组,根据患者血小板计数划分为I级16例、II级18例、III级14例,此外选取同期分娩的50例重度妊娠高血压患者为对照1组,100例同期分娩的正常健康孕妇为对照2组,对比各组患者临床表现、母婴结局及预后情况,统计学处理。结果与对照1组和对照2组相比,重度妊娠高血压合并血小板减少综合征患者妊娠并发症、乳酸脱氢酶、围产儿死亡率较高,对比差异显著(P<0.05),血小板计数较低,对比差异显著(P<0.05);在妊娠并发症发生率方面,对照1组显著高于对照2组,差异显著(P<0.05)有统计学意义,乳酸脱氢酶及围产儿死亡率不存在显著差异;在实验组内,I级组患者的妊娠并发症、乳酸脱氢酶、围产儿死亡率显著高于II级组和III级组患者,差异显著(P<0.05),有统计学意义;II级组患者的乳酸脱氢酶显著高于III级组,血小板计数显著低于III级组,但两组患者在妊娠并发症及围产儿死亡率方面不存在统计学差异(P>0.05)。结论重度妊娠高血压合并血小板减少综合征患者的预后情况与临床等级划分有密切关系,II级组和III级组患者的预后效果优于I级组患者,临床实践中对重度妊娠高血压合并血小板减少综合征患者应进行及时抢救,同时适时终止妊娠能够有效降低产妇并发症发生率及围产儿死亡率,有利于母婴的预后情况。

Objective To investigate the dexamethasone on severe pregnancy induced hypertension complicated with reduced platelet syndrome in patients with clinical efficacy. Methods in our hospital in 2011～2014 48 patients hospitalized during the period of severe pregnancy induced hypertension complicated with reduced platelet syndrome patients as experimental group, according to the patient＇s platelet count is divided into 16 cases, I grade 18 cases of grade Ⅱ, 14 cases of grade Ⅲ, in addition to select 50 patients during the same period of severe pregnancy induced hypertension patients as the control group 1. 100 cases of normal pregnant women during the same period as the control group 2, contrast group patients clinical manifestations, pregnancy outcome and prognosis, statistics processing. Results compared with the control group 1 and control group 2 compared with severe pregnancy induced hypertension complicated with reduced, platelet syndrome in patients with pregnancy complications, lactate dehydrogenase, the perinatal mortality rate is higher, the contrast difference is significant（P〈0.05）, platelet count is low, the contrast difference is significant（P〈0.05）; the incidence of complications in pregnancy and in control group 1 were significantly higher than the control 2 group differences were significant（P〈0.05） with statistical significance, lactate dehydrogenase and perinatal mortality were not significantly different; in the experimental group, the I level in patients with pregnancy complications, group of lactate dehydrogenase and perinatal death rate was significantly higher than that of grade Ⅱ group and the Ⅲ level group with significant difference（P〈0.05）, the difference was statistically significant; lactate dehydrogenase level Ⅱ group patients was significantly higher than that in Ⅲ stage group, platelet count was significantly lower than that of Ⅲ grade group, but the two groups of patients with complications of pregnancy and perinatal mortality rate have no significant difference（P〈0.05）. Conclusion severe pregnancy induced hypertension complicated with reduced platelet syndrome patient＇s prognosis is closely related with the clinical classification, superior prognostic effect of Ⅱ level and Ⅲ level group of groups of patients with I stage patients, the clinical practice of severe pregnancy induced hypertension complicated with reduced platelet syndrome patients should be timely rescue, and timely termination of pregnancy can effectively reduce the incidence of maternal complications and perinatal mortality, there is conducive to mother and infant prognosis.