头颅CT指导重度子痫前期孕妇期待治疗的价值分析

Value of Head CT in Guiding the Expectant Treatment of Pregnant Women with Severe Preeclampsia

目的探讨头颅CT指导重度子痫前期孕妇期待治疗的临床价值。方法收集2017年10月~2018年10月我院收治的重度子痫前期患者120例,均在入院后行头颅CT检查。根据头颅CT检查结果,提示存在颅脑病变者86例,为观察组,无颅脑病变者34例,为对照组,再将86例观察组患者随机分为A、B两组各43例。比较3组患者并发症发生率与围产儿结局差异性。结果 CT结果显示:86例观察组患者中,脑水肿51例(59.30%),脑梗死19例(22.09%),脑血栓11例(12.79%),脑水肿合并脑血栓5例(5.81%);A组患者肝肾功能损伤、心功能不全发生率明显低于B组和对照组(P<0.05);B组与对照组患者并发症发生率比较,3组新生儿窒息、胎死宫内、新生儿体重、胎儿生长受限等围产结局比较,差异均无统计学意义(P>0.05)。结论头颅CT检查有助于发现患者颅内病变,对重度子痫前期孕妇的期待治疗有一定指导意义,在挽救母婴生命的同时可改善围产期结局。

Objective To explore the clinical value of head CT in guiding the expectant treatment of pregnant women with severe preeclampsia. Methods A total of 120 patients with severe preeclampsia admitted to our hospital from October 2017 to October 2018 were collected. All patients were given head CT scan after admission. According to the results of head CT scan, 86 patients with cranial brain lesions were included in observation group, and 34 patients without cranial brain lesions were included in control group. And 86 patients in observation group were randomly divided into group A and group B, with 43 cases in each group. The incidence rate of complications and perinatal outcomes were compared among the three groups. Results CT results showed there were 51 cases(59.30%) of cerebral edema, 19 cases(22.09%) of cerebral infarction, 11 cases(12.79%) of cerebral thrombosis and 5 cases(5.81%) of cerebral edema with cerebral thrombosis among 86 patients in observation group. The incidence rates of liver and kidney function damage and cardiac insufficiency in group A were significantly lower than those in group B and control group(P<0.05). There were no significant differences in the incidence rate of complications between group B and control group and perinatal outcomes of neonatal asphyxia, intrauterine death, neonatal weight and fetal growth restriction among the three groups(P>0.05). Conclusion Head CT examination can help to detect intracranial lesions, and it has certain guiding significance for the expectant treatment of pregnant women with severe preeclampsia. And it can improve the perinatal outcomes while saving the mother and baby life.