2 486例妊娠期高血压疾病患者的临床分析

目的了解近年来南方医科大学附属深圳妇幼保健院收治的妊娠期高血压疾病患者的发病趋势、并发症情况及对妊娠结局的影响。 方法回顾性分析2009年1月至2013年12月在南方医科大学附属深圳妇幼保健院就诊并分娩的2 486例妊娠期高血压疾病患者的临床资料，包括发病率、孕妇年龄、住院天数、分娩方式、流动人口比例及母婴并发症等。 结果5年间我院重度子痫前期发生率呈现下降趋势，从2009年的1.74%降至2013年的1.34%(χ²＝12.321，P<0.05)；流动人口所占比例较高(46.46%)；分娩方式仍然以剖宫产为主(74.09%)，高于阴道分娩(21.44%)，(χ²＝736.084，P<0.001)。妊娠期高血压疾病孕妇严重并发症的构成依次是：产后出血、胎盘早剥、HELLP综合征、心功能不全、弥散性血管内凝血、急性肾衰竭、脑血管意外；其围产儿严重并发症的构成依次为：早产、胎儿生长受限、新生儿窒息、死胎、流产。 结论妊娠期高血压疾病仍是威胁孕产妇以及围产儿健康的严重疾病，必须加强产前保健，早发现、早诊断和早治疗，以改善母婴妊娠结局。

Clinical analysis of the 2 486 patients with hypertensive disorders in pregnancy

ObjectiveTo investigate the clinical incidence trend, complication and pregnancy outcome of hypertensive disorders in pregnancy of Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medical University in recent years. MethodsA retrospective study was conducted in 2 486 patients with hypertensive disorders in pregnancy, who were admitted in Shenzhen Maternity and Child Healthcare Hospital Affiliated to Southern Medical University from January 2009 to December 2013. The clinical data included morbidity, maternal age, days of hospitalization, delivery mode, the proportion of floating population, and the maternal and infant complications. ResultsDuring 5 years, the incidence rate of severe preeclampsia decreased from 1.74% (in 2009) to 1.34% (in 2013), (χ²=12.321, P<0.05). The proportion of floating population was quit high(46.46%). The incidence rate of cesarean section (74.01%) was higher than that of vaginal delivery (21.44%), (χ²=736.084, P<0.001). The ratio of the serious complicationsby hypertensive disorders in pregnancy was postpartum hemorrhage, placental abruption, HELLP syndrome, heart failure, disseminated intravascular coagulation, acute renal failure, and cerebrovascular accident.The ratio of perinatal serious complications was preterm birth, fetal growth restriction, neonatal asphyxia, stillbirth, and abortion. ConclusionsHypertensive disorders in pregnancy is still threating to maternal and perinatal health. The perinatal outcome can be improved through strengthening regular antenatal care, early detection, early diagnosis and early treatment.