重度子痫前期并发胎盘早剥的临床分析

目的:探讨重度子痫前期并发胎盘早剥的临床特征,以便尽早采取干预措施。方法:回顾性分析2005年2月～2009年2月郑州市人民医院产科住院的重度子痫前期患者106例的临床资料。结果:重度子痫前期并发胎盘早剥的发生率为17.92%(19/106)。在胎盘早剥的19例中有3例(15.7%)、未发生胎盘早剥的87例中有62例(71.26%)接受过正规产前检查,两组差异有统计学意义(P<0.05);两组患者收缩压、舒张压波动幅度、合并症(FGR、低蛋白血症、脐血流异常)发生率比较差异有统计学意义(P<0.05)。结论:无规律产前检查、血压波动幅度增加、合并GFR、低蛋白血症、脐血流异常等是重度子痫前期并发胎盘早剥的临床特征。做好产前检查,缓慢平稳降压是防治胎盘早剥的关键。对于合并FGR、低蛋白血症、脐血流异常的重度子痫前期患者应严密监测胎盘早剥的早期征象,并及时干预。

Clinical analysis of severe preeclampsia complicated by placental abruption

Objective:To investigate the clinical features of severe preeclampsia complicated by placental abruption in order to intervene as soon as possible.Methods:From Feb 2005 to Feb 2009,106 inpatients with severe preeclampsia in our hospital were randomly selected.Of the 106 cases,19 patients who had placental abruption were taken as study group,87 patients who had not placental abruption were taken as control group.The clinical data of patients in the two groups were retrospectively analyzed and compared.Results:The incidence of placental abruption complicated by severe preeclampsia was 17.92%(19/106).Three patients(15.7%) in study group and 62 patients(71.26%) in control group were received regular prenatal care,the difference between the two groups was statistically significant(P<0.05).The incidence of the fluctuations of systolic blood pressure and diastolic blood pressure,complications(GFR,hypoproteinemia,abnormal umbilical blood flow) were significantly difference(P<0.05).Conclusion:Irregular prenatal care,increased volatility of blood pressure,mergers GFR,hypoproteinemia,abnormal umbilical blood flow are the clinical features of severe preeclampsia complicated by placental abruption.A good prenatal care,slow smooth step-down blood pressure is the key for prevention and treatment of placental abruption.For the inpatients with severe preeclampsia complicated by placental abruption,the early signs of placental abruption should be closely monitored and timely intervention.