子痫前期并脑血管意外致死亡6例临床分析

目的研究子痫前期并脑血管意外致死亡的病例临床特点,探讨其早期诊断及治疗,以降低孕产妇死亡率。方法对2007年3月至2008年3月广州医学院第三附属医院6例重度子痫前期并脑血管意外致死亡孕产妇的临床资料进行回顾性分析。结果 6例患者中并发脑出血3例,脑梗塞2例,脑卒中（动脉出血）1例;孕周均超过32周,发生在产前4例,产后2例。多以昏迷或抽搐起病,首次检查血压舒张压〉110mmHg,呼吸系统及血液系统受损是脑损伤后最常见受累器官。从发病到死亡时间为5h至9d。新生儿存活5例,死胎1例。结论重度子痫前期并脑血管意外,发病突然,进展迅速,病死率高。治疗的关键在于预防和早期诊断。

Clinical analysis of 6 cases of preeclampsia complicated with cerebrovascular accident

Objective To study the clinical features of 6 cases of severe preeclampsia complicated with cerebrovascular accident, and to discuss the early diagnosis and treatment, in order to reduce maternal mortality. Methods 6 cases with severe preeclampsia complicated with cerebrovascular accident between March 2007 and March 2008 were retrospectively analyzed. Results 3 cases were complicated with cerebral hemorrhage, 2 cases with cerebral infarction, and 1 case with cerebral apoplexy （arterial bleeding）. The gestational age was general greater than 32 weeks. Two cases of complication occurred after birth. Initial symptoms were coma or seizures. During the first examination, the diastolic blood pressure was 〉110 mmHg. Respiratory system and blood circulatory system damage were the most commonly affected organs after brain injury. The death was observed between the first 5 hours after the onset and 9 days after birth. 5 of the infants survived and 1 was death. Conclusions The mortality rate of sudden onset of severe preeclampsia complicated with cerebrovascular accident was high. Early diagnosis and reduction of the blood pressure may reduce the incidence of death.