早发型重度先兆子痫的保守治疗方案

Conservative treatment of early onset severe preeclampsia

目的探讨早发型重度先兆子痫采用保守治疗方案的临床效果。方法选择2013年3月至2015年3月我院收治的160例早发型重度先兆子痫患者作为研究的对象,按照患者不同的孕周将其分为A、B、C、D四组,每组40例,分析四组患者保守治疗的情况以及母婴结局。结果四组的保守治疗时间比较有明显差异(P<0.05),D组保守治疗时间最短;四组的并发症发生情况比较有明显差异(P<0.05),A组并发症发生率最高;四组新生儿死亡率、新生儿窒息率,小于胎龄儿发生率比较有明显差异(P<0.05),A组各项发生率最高;经过Logistic回归分析显示,早发型重度先兆子痫患者的并发症、新生儿死亡、新生儿窒息、小于胎龄的发生率均与发病孕周呈正相关(OR=1.256,1.012,1.952,1.0853,P<0.05),以32周作为临界值,新生儿死亡以及新生儿窒息危险因素为终止妊娠孕周(OR=1.943,1.025,P<0.05)。结论早发型重度先兆子痫患者以孕周32周作为临床界定值,能够反映出发病孕周与分娩结局之间的关系,在实施保守治疗时应当严格把握适应证,改善母婴结局。

Objective To investigate the clinical effect of conservative treatment of early onset severe preeclampsia. Methods One hundred and sixty cases of early onset severe preeclampsia from March 2013 to March 2015 in our hospital were selected as the research objects and divided into four groups： group A, group B, group C and group D according to the different gestational weeks, with 40 cases in each group. The effect of the conservative treatment and mother-infant end were analyzed among the four groups. Results The conservative treatment time in the four groups had significant difference （P〈 0.05）, and the group D had the shortest conservative treatment time; the complications of the four groups were significantly different （P〈0.05）, the complication rate of group A was the highest; there was significant difference between the four groups in neonatal mortality rate, neonatal asphyxia rate and the incidence rate of less than gestational age （P〈0.05）, and the incidence rate in group A was the highest. Logistic regression analysis showed that the incidence rate of complications, neonatal death, neonatal asphyxia, and the incidence rate of less than gestational age of early onset severe preeclampsia were positively correlated with the gestational age （0R=1.256, 1.012, 1.952, 1.0853, P〈0.05）, with 32 weeks as the critical value, the risk factors of neonatal death and neonatal asphyxia were termination of pregnancy （0R=1.943, 1.025, P〈0.05）. Conclusion With 32 weeks as the critical value for early onset severe preeclampsia, this valu can reflect the relationship between gestation age and mother-infant end, conservative treatment should obey the restricted indication to improve the mother-infant end.