期待疗法治疗36例重度子痫前期疗效观察

Observation of curative effect of expectant therapy on 36 cases of severe preeclampsia

目的:探讨期待疗法治疗重度子痫前期的临床疗效。方法:收治重度子痫前期患者36例,随机分成A、B、C 3组。所有患者入院后完善相关检查,间断吸氧,卧床休息,给予营养膳食,并密切监测母胎情况,根据病情确定终止妊娠的时机和方式;若期待治疗不明显,一旦出现母、儿并发症,应终止妊娠,并适时使用地塞米松促进胎儿肺成熟。结果:A组剖宫产4例,剖宫产率33.3%,B组剖宫产6例,剖宫产率50.0%,C组剖宫产9例,剖宫产率75.0%,组间差异有统计学意义(P<0.05)。随着期待时间的延长,母、儿并发症也逐步增多,C组明显多于A组和B组。结论:重度子痫前期期待疗法2 d之内没有效果,则可以考虑终止妊娠,若继续维持妊娠7~10 d临床效果较好,若期待疗法>14 d则母婴的风险明显增大。

Objective:To explore the curative effect of expectant therapy on severe preeclampsia.Methods:36 patients with severe preeclampsia were selected,and they were randomly divided into the A group,the B group and the C group.After admission,all patients were given related inspection,oxygen inhalation,bed rest and nutritional diet.We closely monitored the conditions of pregnant women and fetuses.According to the condition,we determined the timing and method of termination of pregnancy.If the expectant therapy was not obvious,the pregnant woman will be given the termination of pregnancy immediately if there were complications of mother and infant,and we used dexamethasone in time to promote fetal lung maturation.Results:Cesarean section was performed in 4 cases in the A group,and the rate of cesarean section was 33.3%.Cesarean section was performed in 6 cases in the B group,and the rate of cesarean section was 50.0%;cesarean section was performed in 9 cases in the C group,and the rate of cesarean section was 75.0%;the difference among the three groups was statistically significant(P<0.05).With the prolongation of waiting time,the complications of mother and infant increased gradually,and the C group was significantly more than the A group and the B group.Conclusion:Expectant therapy on severe preeclampsia had no effect within 2 days,and termination of pregnancy can be considered.The clinical effect was better if the pregnancy was continued for 7 to 10 days.If the expectant treatment was more than 14 days,the risk of mother and infant was obviously increased.