子痫抽搐与围产儿预后的相关性

Association of the convulsions and perinatal prognosis in 81 cases with eclampsia

目的：分析81例子痫抽搐临床特点及与围产儿预后的相关性,探讨规范子痫抽搐临床处置和改善预后。方法：回顾2009年1月1日至2014年12月30日本院收治符合子痫诊断标准且资料较完整的病例81例,对其各项临床特征进行统计学分析。结果：本院子痫发病率为0.24%。产前子痫占64.20%,产时子痫占9.88%,产后子痫占23.46%,产前、产后均发生子痫占2.47%。早产占70.37%,新生儿窒息占43.21%,围产儿死亡占22.22%。抽搐次数1、2、≥3次者各组间新生儿窒息率、早产率差异无统计学意义（P〉0.05）,而围产儿死亡率分别为12.24%、28.57%和44.44%,差异有统计学意义（P〈0.05）;按发病孕周分为≤28、28＋1-33＋6和≥34周3组,3组新生儿窒息率差异无统计学意义（P〉0.05）,但围产儿死亡率分别为75.00%、14.81%和17.39%,差异有统计学意义（P〈0.05）。60例产前、产时子痫末次抽搐距离分娩时间长短与新生儿窒息率、围产儿死亡率及转新生儿重症监护室率差异无统计学意义（P〉0.05）;子痫合并低蛋白血症组新生儿窒息率、围产儿死亡率差异无统计学意义（P〉0.05）。结论：子痫患者早产率、新生儿窒息率及围产儿死亡率极其高。子痫发生的孕周越小、抽搐次数越多,围产儿预后不良风险越高,而低蛋白血症与围产儿预后无明显相关性。

Objective To investigate the association of the convulsions and perinatal prognosis in 81 cases with eclampsia and to explore the clinical disposal strategies and suggestions for improving the prognosis of eclampsia. Methods A retrospective chart review was performed on admissions from January 1,2009 to December 30,2014. Eighty-one women who had been hospitalized with eclampsia in the third affiliated hospital of Guangzhou medical university were enrolled. Results The incidence of eclampsia was 0.24 %（81/33084）. The incidence of the nosocomial eclampsia was 44.44% （36/81） and the outside hospital of eclampsia was 55.55% （45/81）. The antepartum eclampsia was 64.20% （52/81）, the intrapartum eclampsia was 9.88% （8/ 81）,the postpartum eclampsia was 23.46% （19/81）, and the eclampsia occurred both in trapartum and postpartum was 2.47% （2/81）. Preterm births accounted for 70.37% （57/81）, neonatal asphyxia accounted for 43.21% （35/81）, perinatal deaths accounted for 22.22% （18/81）. No significant differences were found in the rate of preterm birth and neonatal asphyxia among different convulsion times, but the perinatal mortality was significantly higher in tic 3 times.There was no significant differences in the rate of neonatal asphyxia among different gestational weeks, but the perinatal mortality was significantly higher in less than 28 gestational weeks. No significant differences were observed among the rate of neonatal asphyxia, perinatal mortality and the rate of neonatal intensive care unit in 60 cases of antepartum and intrapartum eclampsia. The rate of neonatal asphyxia in eclampsia with hypoalbuminemia group was slightly high than that in the no hypoalbuminemia group, but with no significant difference. Conclusion The perinatal prognosis of eclampsia including premature birth rate, neonatal asphyxia rate and perinatal mortality were higher in pregnants with small gestational weeks and convulsions more times.However, no correlation was found between the perinatal prognosis and hypoalbuminemia.