摘要
目的 探讨早发型重度子痫前期患者终止妊娠的时机及分娩方式对母婴的影响.方法 将我院115例早发型重度子痫前期患者按终止妊娠孕周分为4组：A组＜32周,B组32～33＋6周,C组34～35＋6周,D组≥36周.按分娩方式分为两组：阴道分娩组和剖宫产组.比较各组围生儿结局及孕产妇并发症发生率.结果 不同终止妊娠孕周的早发型重度子痫前期患者其围生儿死亡率间差异有统计学意义（χ2=50.323,P＜0.05）,新生儿窒息率间差异亦有统计学意义（χ2=17.939,P＜0.05）,而孕产妇并发症发生率间差异无统计学意义（χ2=0.981,P＞0.05）.终止妊娠孕周34～35＋6周的早发型重度子痫前期患者与终止妊娠孕周≥36周者比较,围生儿死亡率（χ2=0.000,P＞0.05）、新生儿窒息率（χ2=0.008,P＞0.05）及孕产妇并发症发生率（χ2=0.000,P＞0.05）间差异均无统计学意义.剖宫产组新生儿窒息率（50.0%,38/76）、围生儿死亡率（40.8%,31/76）均低于阴道分娩组（新生儿窒息率为82.4%、围生儿死亡率为64.7%）,两组比较差异有统计学意义（P＜0.05）.结论 早发型重度子痫前期患者延长孕周至34周后终止妊娠围生儿结局较好,合理采用剖宫产能有效降低新生儿窒息发生率及围生儿死亡率.
Objective To study the effect of different termination times of pregnancy and childbirth ways in early onset severe preeelampsia on the perinatal outcomes. Methods 115 patients with early onset severe preeelampsia were divided into four groups according to the termination times of pregnancy： group A with a termination time of less than 32 weeks, group B with a termination time of 32 -33 ＋6weeks, group C with a termination time of 34 - 35 ＋6 weeks and group D with a termination time more than 36 weeks. The patients were divided into two groups according to the childbirth ways： group A with the childbirth way of vagina delivery ; group B with the childbirth way of cesarean section. Results The perinatal infant mortality rate varied significantly with different termination time （ X^2 = 50. 323, P 〈 0. 05）, difference of neonatal asphyxia rate was also significant （ X2 = 17. 939, P 〈 O. 05 ） , but the difference of complication rate showed no statistical difference （ X2 = 0. 981, P 〉 0.05 ）. The pefinatal infant mortality rate （ X2 = 0. 000, P 〉 0. 05 ）, neonatal asphyxia rate （ X2 = 0. 008, P 〉 0. 05） and complication rate of pregnant women （X2 =0. 000, P 〉0. 05） in patients with termination time of 32 -33 ＋6weeks and more than 36 weeks showed no statistical difference. In cesarean section group, neonatal asphyxia rate （50. 0% , 38/76） and perinatal infant mortality rate （40. 8%, 31/76） were both significantly lower than that of the vagina delivery group （82. 4% and 64. 7% respectively） （P 〈 0. 05）. Conclusion The termination time of early onset severe preeclampsia patients should be prolonged to after 34 - weeks, which can improve the perinatal outcome. Reasonable use of the cesarean section can obviously reduce the perinatal infant mortal- ity rate and neonatal asphyxia rate.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第3期267-268,271,共3页
Chinese General Practice
关键词
早发型重度子痫前期
分娩方式
终止妊娠时机
围产儿结局
Early onset severe preeclampsia
Childbirth way
Termination times of pregnancy
Perinatal outcome
