【摘要】 目的:分析早发型重度子痫前期期待治疗对母婴预后的影响。方法:分析早发型重度子痫前期患者260例,并根据入院孕周分为3组,A组为孕周<28周(35例),B组为28周≤孕周<32周(116例),C组为32周≤孕周<34周(109例);根据治疗时间又分为4组,Ⅰ组为治疗时间<48h(77例),Ⅱ组为48h≤治疗时间<7天(71例),Ⅲ组为7天≤治疗时间<14天(89例),Ⅳ组为治疗时间≥14天(23例)。比较不同孕周及不同期待治疗时间与各种母胎并发症及围产儿结局的关系。结果:早发型重度子痫前期孕妇最易发生肝肾功能受损、胎盘早剥等并发症。不同治疗时间各组孕妇并发症的发生情况,Ⅳ组明显高于其余3组,差异有统计学意义(P<0.05),而Ⅰ、Ⅱ、Ⅲ组间差异无统计学意义。A组胎死宫内、新生儿窒息、新生儿死亡率明显高于B、C组(P<0.05),而Ⅰ组发生胎死宫内、新生儿窒息、新生儿死亡的机率明显高于其余3个组(P<0.05)。结论:早发型重度子痫前期发病越早,越容易发生母儿并发症,严重威胁孕产妇和胎儿的安危。在严密监护母胎情况下期待治疗7～14天可明显改善围生儿结局,而孕产妇并发症的发生率无明显增加。更多还原

【Abstract】 Objective:To analyze the effect of expectant management in early onset severe preeclampsia on maternal and neonatal outcomes.Methods:260 patients with early onset severe preeclampsia were divided into three groups according to gestational weeks on admission:A group(gestational weeks<28 weeks,35 cases),B group(28 weeks≤gestational weeks<32 weeks,116 cases),C group(32 weeks≤gestational weeks<34 weeks,109 cases);then they were divided into four group according to treatment time:group Ⅰ(<48 hours,77 cases),group Ⅱ(48 hours～7 days,71 cases),group Ⅲ(7～14 days,89 cases),group Ⅳ(≥14 days,23 cases),the relationship between different gestational weeks/treatment times and maternal and fetal outcomes,perinatal outcomes were compared.Results:The patients with early onset severe preeclampsia are prone to liver and renal diseases,placental abruption,the incidence of maternal complications in group Ⅳ was significantly higher than those in the other three groups(P<0.05),but there was no difference among group Ⅰ,group Ⅱ and group Ⅲ.The incidences of intrauterine fetal death,neonatal asphyxia and neonatal death in A group were significantly higher than those in B group and C group(P<0.05),and the incidences of intrauterine fetal death,neonatal asphyxia and neonatal death in group Ⅰ were significantly higher than those in the other three groups(P<0.05).Conclusion:The earlier occurrence of early onset severe preeclampsia,the higher incidence of maternal and neonatal complications is,which affects maternal and neonatal outcomes seriously.On the basis of comprehensive monitoring,expectant management for 7～14 days can improve the perinatal outcomes significantly,which don’t increase the incidence of maternal complications.更多还原