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目的 :探讨628例重度子痫前期患者的临床特点、并发症及妊娠结局。方法 :回顾性分析2010年1月—2015年6月在南京医科大学第一附属医院产科住院并分娩的628例重度子痫前期患者的临床资料,分析患者发病率、孕妇年龄、分娩方式、母婴并发症及胎龄28~34周活产新生儿预后等情况。结果:重度子痫前期初产妇多于经产妇,21~35岁多发,早发型重度子痫前期患者多于晚发型重度子痫前期。严重并发症的构成依次是:产后出血、胎盘早剥、HELLP综合征、心功能不全、弥散性血管内凝血、急性肾衰竭、脑血管意外;其围产儿严重并发症的构成依次为:早产、胎儿生长受限、新生儿窒息、胎儿窘迫、死胎。早发型子痫前期胎盘早剥、HELLP综合征、脑血管意外、胎儿生长受限、胎儿窘迫、重度窒息儿、早产儿等母婴并发症的发生率高于晚发型重度子痫前期。分娩方式仍然以剖宫产为主。胎龄28~34周活产新生儿随胎龄增加,存活力明显增加。结论:重度子痫前期易并发严重并发症,威胁孕产妇以及围产儿生命安全,应得到广泛重视。随终止妊娠孕周增加,围产儿预后明显改善。
Objective: To investigate the clinical features, complications and pregnancy outcomes of 628 patients with severe preeclampsia. Methods: The clinical data of 628 patients with severe preeclampsia hospitalized and delivered in the obstetrics department of the First Affiliated Hospital of Nanjing Medical University from January 2010 to June 2015 were retrospectively analyzed. The incidence of the patients, the age of the pregnant women, mode of delivery, Infant complications and gestational age of 28 to 34 weeks live birth neonatal prognosis and so on. Results: The number of primipara in severe preeclampsia was higher than that in maternal women, with 21-35 years old. There were more patients with preeclampsia and severe preeclampsia than those with late onset severe preeclampsia. The composition of serious complications were as follows: postpartum hemorrhage, placental abruption, HELLP syndrome, cardiac insufficiency, disseminated intravascular coagulation, acute renal failure, cerebrovascular accident; its perinatal complications are: preterm birth, Fetal growth restriction, neonatal asphyxia, fetal distress, stillbirth. Early onset of preeclampsia placental abruption, HELLP syndrome, cerebrovascular accident, fetal growth restriction, fetal distress, severe asphyxia, premature children and other maternal and child complications higher incidence of late onset severe preeclampsia. Mode of delivery is still the main cesarean section. The gestational age of newborns with gestational age increased from 28 to 34 weeks and their viability increased significantly. Conclusions: Severe preeclampsia complicated by serious complications threatening the life safety of pregnant women and perinatal children should receive extensive attention. With the increase of gestational age at termination of pregnancy, the prognosis of perinatal children is significantly improved.