早发型重度子痫前期保守治疗对早产儿预后的影响分析

Effect analysis of conservative treatment on prognosis of premature infants with early-onset severe preeclampsia

目的探讨早发型重度子痫前期保守治疗对早产儿预后的影响。方法选取60例早发型重度子痫前期患者作为研究组,给予保守治疗;另选择60例自发性早产患者作为对照组,只观察早产情况,不采取保守治疗。比较研究组患者治疗前后血压(收缩压、舒张压)、24 h尿蛋白定量及羊水指数(AFI)、凝血功能指标[(凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)]、脐动脉血流指标[搏动指数(PI)、阻力指数(RI)、脐动脉收缩期峰值流速/舒张末期最大流速(S/D)];比较两组早产儿存活及智能发育情况、出生体重;分析研究组早产儿不同出生体重和胎龄发育情况。结果治疗后,研究组患者收缩压(126.28±7.12)mm Hg(1 mm Hg=0.133 kPa)、舒张压(91.46±4.85)mm Hg、24 h尿蛋白定量(4.27±1.25)g/24 h、D-D(3.46±0.51)mg/L、FIB(5.11±0.52)g/L、PI(1.02±0.16)、RI(0.62±0.07)、S/D(2.75±0.63)均低于治疗前的(151.37±8.57)mm Hg、(96.91±8.55)mm Hg、(5.69±1.71)g/24 h、(3.72±0.42)mg/L、(5.72±0.74)g/L、(1.23±0.17)、(0.72±0.09)、(3.15±0.48),AFI(6.71±0.74)cm高于治疗前的(5.51±0.63)cm,PT(11.37±1.02)s、APTT(34.12±1.02)s长于治疗前的(10.08±1.05)、(33.06±2.85)s,差异具有统计学意义(P<0.05)。研究组早产儿存活率为88.33%(53/60),与对照组的96.67%(58/60)比较差异无统计学意义(P>0.05)。研究组早产儿智能发育正常率为90.57%(48/53),与对照组的93.10%(54/58)比较差异无统计学意义(P>0.05)。两组早产儿出生体重比较差异无统计学意义(P>0.05)。研究组不同出生体重早产儿胎龄比较差异具有统计学意义(P<0.05)。胎龄越大,早产儿出生体重越高。结论早发型重度子痫前期患者经保守治疗后各项临床指标得到有效控制,早产儿预后得到明显改善,值得临床推广应用。

Objective To discuss the effect of conservative treatment on prognosis of premature infants with early-onset severe preeclampsia.Methods 60 patients with early-onset severe preeclampsia were selected as the research group and received conservative treatment;another 60 patients with spontaneous preterm delivery were selected as the control group and only preterm delivery was observed without conservative treatment.Comparison was made on blood pressure(systolic blood pressure and diastolic blood pressure),24-h urinary protein quantification and amniotic fluid index(AFI),coagulation indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)],umbilical artery flow indexes[pulsatility index(PI),resistance index(RI),peak systolic velocity/end diastolic velocity(S/D)]before and after treatment in the research group,as well as survival,intellectual development,and birth weight of premature infants in the two groups;the different birth weight and gestational age of premature infants were analyzed in the research group.Results After treatment,the research group had systolic blood pressure of(126.28±7.12)mm Hg(1 mm Hg=0.133 kPa),diastolic blood pressure of(91.46±4.85)mm Hg,24 h urinary protein quantification of(4.27±1.25)g/24 h,D-D of(3.46±0.51)mg/L,FIB of(5.11±0.52)g/L,PI of(1.02±0.16),RI of(0.62±0.07),and S/D of(2.75±0.63),which were lower than those of(151.37±8.57)mm Hg,(96.91±8.55)mm Hg,(5.69±1.71)g/24 h,(3.72±0.42)mg/L,(5.72±0.74)g/L,(1.23±0.17),(0.72±0.09),and(3.15±0.48)before treatment;AFI of(6.71±0.74)cm in the research group was higher than that of(5.51±0.63)cm before treatment;PT of(11.37±1.02)s and APTT of(34.12±1.02)s in the research group were longer than those of(10.08±1.05)and(33.06±2.85)s before treatment;the differences were statistically significant(P<0.05).The survival rate of premature infants in the research group was 88.33%(53/60),and there was no statistically significant difference compared with 96.67%(58/60)in the control group(P>0.05).The normal rate of intelligent development of premature infants in the research group was 90.57%(48/53),and there was no statistically significant difference compared with 93.10%(54/58)in the control group(P>0.05).There was no statistically significant difference in birth weight between the two groups(P>0.05).The gestational age of premature infants with different birth weight was significantly different in the research group(P<0.05).The greater the gestational age,the higher the birth weight of premature infants.Conclusion After conservative treatment,various clinical indicators of patients with early-onset severe preeclampsia have been effectively controlled,and the prognosis of premature infants has been significantly improved,which is worthy of clinical promotion and application.