早发型重度子痫前期的临床监控防范

目的探讨早发型重度子痫前期终末器官损害及其监测指标，指导期待治疗、个体化处理以降低母婴死亡率。方法对早发型重度子痫前期34例患者（A组），晚发型重度子痫前期45例患者（B组）进行回顾性分析，监测各项实验室指标及临床指标。结果早发型组肝损害、血小板减少、D二聚体升高、血脂升高、LDH升高、抗心磷脂抗体阳性的发生率高于晚发型组（P〈0．05），而肾功能损害、眼底改变、低蛋白血症、子痫、心衰，肺水肿、脑血管意外等发生率之间差异则无统计学意义（P〉0．05）。同时，早发型组的FGR、死胎、新生儿窒息发生率比晚发型组高（P〈0．05）。结论早发型重度子痫前期母体可发生严重并发症，伴有较高FGR发生率，通过严密监测各项指标，进行个体化处理是改善母婴预后的关键。

Clinical monitoring and precaution of early onset severe preeclampsia

Objective To investigate the end-organ damage and monitoring indicators of early onset severe preeclampsia, and to provide guidance for the expecting therapy and individual treatment and thus reduce the maternal and perinatal mortality. Methods The clinical data of 34 pregnant women of early onset severe preeclampsia (group A) and 45 pregnant women of late onset severe preeclampsia (group B) were retrospectively analyzed.Results The incidence of hepatic lesion, thrombocytopenia, increased D-dimeride, increased blood fat, increased LDH, anticardiolipin antibody masculine were significantly higher in group A than group B (P<0.05). No statistically significant differences were found in renal failure, eyeground blooding, hypoalbuminosis, eclampsiwas, heart failure/lung edema, and cerebral accident between the two groups (P>0.05). The incidence of fetal growth restriction (FGR), fetal death, apnoea neonatorum were significantly higher in group A than group B (P<0.05). Conclusion Early onset severe preeclampsia is often complicated with a variety of serious complications, with high incidence of FGR. The clinical monitoring of clinical indicators and individual treatment are the key to improve the perinatal outcome.