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目的:比较不同孕周早发型重度子痫前期(EOSP)期待治疗的妊娠结局,探讨期待治疗临床价值。方法:随机选择150例EOSP患者作为研究对象,其中孕25～27+6周40例(A组),孕28～31+6周60例(B组),孕32～33+6周50例(C组),入院予镇静、解痉、降压,扩容、利尿等期待治疗。结果:A组期待治疗时间(6.67±4.23)天、B组(17.12±6.34)天、C组(7.12±3.67)天,B组最长(P<0.05);孕妇并发症A组25.00%高于B组的11.67%、C组的8.00%(P<0.05);3组新生儿出生Apgar评分分别为A组(4.45±2.12)、B组(7.65±1.47)、C组(8.02±1.42),A组最低(P<0.05);围生儿死亡率为A组77.50%、B组16.67%、C组12.00%,A组最高(P<0.05)。B组、C组孕妇并发症及围生儿情况比较无统计学差异(P>0.05)。结论:EOSP患者终止妊娠时间应根据母亲胎儿双方面情况而定,小于28周EOSP患者保守治疗被认为是不可行;孕32周不必过分强调保胎,可考虑终止妊娠;对于孕28～31+6周EOSP患者可以实施期待治疗。
OBJECTIVE: To compare the expectation outcome of early gestational age-severe preeclampsia (EOSP) and explore the clinical value of expectant treatment. Methods: A total of 150 EOSP patients were selected as the research object. Among them, 40 cases (group A) from 25 weeks to 27 + 6 weeks and 60 cases (group B) from 28 to 31 + 6 weeks and 50 cases from 32 weeks to 33 + 6 weeks (C group), admission to sedation, spasmolytic, antihypertensive, dilatation, diuretic waiting for treatment. Results: The duration of treatment in group A was (6.67 ± 4.23) days, in group B (17.12 ± 6.34) days, in group C (7.12 ± 3.67) days and in group B the longest (P <0.05) 11.67% in group B and 8.00% in group C (P <0.05). Apgar scores of newborns in group A were 4.45 ± 2.12 in group A, 7.65 ± 1.47 in group B and 8.02 ± 1.42 in group C respectively , And the lowest in group A (P <0.05). The rate of perinatal mortality was 77.50% in group A, 16.67% in group B, 12.00% in group C, and the highest in group A (P <0.05). There was no significant difference in complications between pregnant women in B group and C group and in perinatal children (P> 0.05). Conclusions: EOSP termination of pregnancy should be based on both aspects of the fetus of mothers, conservative treatment of EOSP patients less than 28 weeks is considered infeasible; 32 weeks of pregnancy need not be too much emphasis on miscarriage, termination of pregnancy can be considered; for pregnant 28 ~ 31 + Six weeks EOSP patients can be expected to be treated.