摘要
目的 :探讨孕 2 8～ 32周重度妊高征期待治疗疗程长短对母儿结局的影响。方法 :1993年 1月至 2 0 0 4年 2月收治孕 2 8～ 32周重度妊高征 35例 ,积极治疗组 6例 (A组 ,治疗时间未满 4 8h) ,短疗程期待治疗组 15例 (B组 ,≤ 11d)和长疗程期待治疗组 14例 (C组 ,>11d) ,比较期待治疗两组的母儿结局。结果 :(1)期待治疗两组的孕妇确诊孕周 ,确诊时收缩压和舒张压 ,2 4h尿蛋白定量和肾功能差异无显著性 (P >0 .0 5 ) ;(2 )C组孕妇重要脏器损害累积数高于B组 (0 .93vs 0 .80 ) ,但差异无显著性。除了A组外 ,胎儿窘迫和小于胎龄儿总发生率分别为 4 8.3%和 34.4 8% ,B组明显低于C组 (2 6 .7%vs 71.4 % ,18.18%vs 5 3.85 % ,P<0 .0 5 )。两组新生儿体重、窒息发生率、NICU天数和住院天数、新生儿患病率差异无显著性 ;(3)除了由于失误导致围产儿死亡以外 ,总围产儿死亡率 15 1.5‰ ,A组、B组和C组围产儿死亡率分别为 2 0 0‰、83.3‰、187.5‰ ,B组显著低于C组 (P <0 .0 5 )。结论 :(1)对早发型重度妊高征进行期待治疗之前 ,应对母儿进行细致、充分的评估 ;(2 )早发型重度子痫前期期待治疗应有期限。
Objective:To explore the impact of the duration of expectant mana gement on the fetaomaternal outcome in severe pregnancy-induced hypertension at 28～32 weeks′ gestation.Method:35 cases with severe pregnan c y-induced hypertension at 28～32 weeks′ gestation were diagnosed and treated between Jan.1993 and Feb.2004. They were divided into three groups: aggr ess ive management(group A,6 cases),short-term expectant management (group B, 15 ca s es) and long-term expectant management(group C,14 cases). The fetaomaternal out c ome was compared. Results:(1)At the time of admission there w ere no differences b etween the two groups of expectant management in mean systolic blood pressure, m ean diastolic blood pressure, 24-hour urinary protein excretion, renal function and gestational age.(2)The average pregnancy prolongation in group C was 21.7day s (range 12 to 34 day),longer than that in group B(mean 6.6days, range 3 to 11 day ).(3)The n umber of important impaired organs in group C was more than that in group B, but t he differences had no significant. The total rate of fetal distress and small fo r gestational age was 48.3% and 34.48% except for group A. Those in group C were higher than those in group B. The total incidence of perinatal death was 151.5 ‰ except for the perinatal death due to the fault, and that in group C was high er than that in group B(187.5‰ vs 83.3‰,P<0.05).(4)There we re no difference between two expectant management groups in mean birth weight,rate of asphyxia ne o natorum, mean days of hospitalization in the neonatal intensive care unit,total hospital stay and incidence of neonatal complications.Conclusion:(1)Sufficient and careful assessment is needed for the ma ternal and infant status before determining the expectant management for the gravi da of sever e pregnancy-induced hypertension at 28～32 weeks′ gestation.(2)The duration of expectant management should be limited.
出处
《现代妇产科进展》
CSCD
2004年第6期449-452,共4页
Progress in Obstetrics and Gynecology
