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目的:分析早发型重度子痫前期的临床特点、并发症及围产儿结局。方法:收集重度子痫患者66例,以孕34周为界分为早发型和晚发型2组,早发型22例(A组),晚发型44例(B组)。分析两组的临床症状、体征、妊娠并发症、围产儿结局。结果:①A组脏器损害发生率明显高于B组:A、B两组尿蛋白阳性率分别为100.00%(22/22)、47.73%(21/44),两组比较差异有显著性(P<0.05);A、B两组肌酐升高率分别为50.00%(11/22)、18.18%(8/44),两组比较差异有显著性(P<0.05);A、B两组腹水发生率分别为31.82%(7/22)、9.09%(4/44),两组比较差异有显著性(P<0.05)。②妊娠严重并发症发生率:A组50.00%(11/22),B组18.18%(8/44),两组比较差异有显著性(P<0.05)。③新生儿重度窒息率:A组25.00%(6/24),B组2.13%(1/47),两组比较差异有显著性(P<0.05);胎儿和新生儿死亡发生率:A组20.83%(5/24),B组2.13%(1/47),两组比较差异有显著性(P<0.05)。结论:严重蛋白尿是早发型重度子痫的临床特点,继续妊娠可出现肌酐升高及肾功能损害;早发型重度子痫前期妊娠并发症和围产儿不良结局发生率较高。
Objective: To analyze the clinical features, complications and perinatal outcome of early-onset severe preeclampsia. Methods: 66 patients with severe eclampsia were divided into two groups: early onset and late onset, with 34 cases of early onset and late onset, 22 cases of early onset (group A) and 44 cases of late onset (group B). The clinical symptoms, signs, complications of pregnancy and perinatal outcome were analyzed. Results: ①The incidence of organ damage in group A was significantly higher than that in group B: The positive rates of urinary protein in groups A and B were 100.00% (22/22) and 47.73% (21/44) respectively, with significant difference between the two groups P <0.05). The rates of creatinine increase in groups A and B were 50.00% (11/22) and 18.18% (8/44) respectively, with significant difference between the two groups (P <0.05) The incidence of ascites was 31.82% (7/22) and 9.09% (4/44), respectively, with significant difference between the two groups (P <0.05). The incidence of serious complications of pregnancy was 50.00% (11/22) in group A and 18.18% (8/44) in group B, with significant difference between the two groups (P <0.05). ③ Severe neonatal asphyxia rate: A group 25.00% (6/24), B group 2.13% (1/47), the difference between the two groups was significant (P <0.05); fetal and neonatal mortality: A group 20.83% (5/24) in group B and 2.13% (1/47) in group B respectively. There was significant difference between the two groups (P <0.05). Conclusions: Severe proteinuria is a clinical feature of early-onset severe eclampsia. Continuous pregnancy may lead to elevated creatinine and renal dysfunction. Pregnancy complications of early-onset severe preeclampsia and perinatal adverse outcomes are higher.