早发型重度子痫前期期待治疗的临床研究

目的分析早发型重度子痫前期期待治疗时限及妊娠结局。方法选择无严重并发症早发型重度子痫前期病人66例,以其终止妊娠前孕周分为3组,A组发病孕周<28周(10例),B组发病孕周为28~31+6周(24例),C组发病孕周32~33+6周(32例)。分析3组孕期治疗时限、孕妇并发症、胎儿及围生儿结局。结果 3组孕妇并发症发生率随着孕周的延长有升高的趋势,但差异无显著性(P>0.05)。胎儿窘迫、胎死宫内、新生儿窒息及新生儿死亡的发生率随孕周增长而下降,差异有显著性(P=0.000~0.006)。B组的期待治疗时间明显较A、C组长(F=7.572,q=7.587、6.457,P<0.05),而A组和C组比较差异无显著性(P>0.05)。3组剖宫产率比较差异无显著性(P>0.05)。结论早发型重度子痫前期非手术治疗可行,但在治疗中应严密监测,权衡利弊,适时终止妊娠,剖宫产仍是终止重度子痫前期的主要治疗方法。

CLINIC STUDY OF EXPECTANT MANAGEMENT OF EARLY-ONSET SEVERE PREECLAMPSIA

Objective To analyze the time limit and pregnancy outcome of expectant management for early-onset severe preeclampsia(EOSP).Methods Sixty-six EOSP patients with no severe complications were enrolled and divided into three groups based on gestational weeks before termination of pregnancy: group A,10 cases,onset before 28 weeks of pregnancy;group B,24 cases,28-31+6 weeks of gestation;group C,32 cases,28-31+6 weeks of gestation.Timing of therapy at duration of pregnancy,complications of pregnant women,and fetal and prenatal outcome were analyzed.Results An incidence of complications in the gravida increased with the weeks of gestation in the three groups,with no significant differences among them(P>0.05).The rates of fetal distress,fetal death,neonatal asphyxia and neonatal mortality decreased with the increase of gestational weeks,the differences were significant(P=0.000-0.006).The time of expectant treatment for patients in group B was longer than that of groups A(F=7.572;q=7.587;P<0.05) and C(q=6.457,P<0.05),while the differences were not significant between groups A and C(P>0.05).The rate of cesarean section was not significant among the three groups(P>0.05).Conclusion Non-surgical therapy is feasible for EOSP under close monitoring to weigh the merits and demerits,and termination of pregnancy to be carried out at the right moment as needed,and Cesarean section is still the main procedure for this condition.