慢性高血压合并妊娠164例妊娠结局分析

发布时间：2018-04-22 17:49

  本文选题：慢性高血压 + 附加型子痫前期　； 参考：《苏州大学》2014年硕士论文

【摘要】：目的：探讨慢性高血压合并妊娠对围生期结局的影响，，以及发生附加子痫前期的危险因素。 方法：选择苏州大学附属第一医院2011年10月~2013年11月间收治的164例行正规产检的慢性高血压合并妊娠孕妇为研究对象。根据其是否并发子痫前期分为慢性高血压合并子痫前期组（PE组，80例）和慢性高血压未并发子痫前期组（N—PE组，84例）。比较两组患者的并发症和胎儿预后情况，探讨导致母儿不良预后的高危因素。 结果：（1）PE组胎盘早剥和产后出血的发生率明显高于N-PE组（8.8%vs.1.2%，12.5%vs.2.4%；P＜0.05）。（2）PE组平均分娩孕周小于N-PE组，差异明显（35.3±4.1vs.38.1±2.4；P＜0.001）；两组＜37周早产、＜34周早产、＜32周早产率分别比较，PE组高于N-PE组，差异有统计学意义（P＜0.001）。（3）胎儿宫内生长受限发生率PE组高于N-PE组（26.3%vs.7.1%，P＜0.05）。（4）新生儿转NICU发生率，PE组高于N-PE组，差异有统计学意义（33.7%vs.10.7%，P＜0.001）。（5）单因素分析：年龄＞35岁、妊娠初期基础血压为重度高血压、平均动脉压≥114mmHg、肥胖、高血压家族史是影响慢性高血压合并妊娠患者在正规产检情况下发生附加子痫前期的危险因素；而多因素logistic回归分析显示：平均动脉压≥114mmHg、肥胖是影响慢性高血压合并妊娠患者在正规产检情况下并发子痫前期的独立危险因素（ORs:7.018、2.656；95%CIs:2.684-18.354、1.045-6.749）。结论：慢性高血压合并子痫前期患者的母儿病率和围产儿病死率明显高于未合并子痫前期患者，平均动脉压≥114mmHg、肥胖是慢性高血压合并妊娠患者在正规产检情况下并发子痫前期的独立因素。
[Abstract]:Objective: to investigate the effect of chronic hypertension combined with pregnancy on perinatal outcome and the risk factors of preeclampsia. Methods: 164 pregnant women with chronic hypertension and pregnancy were selected from October 2011 to November 2013 in the first affiliated Hospital of Suzhou University. According to whether preeclampsia was complicated by chronic hypertension and preeclampsia, 80 patients were divided into two groups: chronic hypertension with preeclampsia (n = 80) and chronic hypertension without preeclampsia (n = 84) with preeclampsia (n = 84). The complications and fetal prognosis of the two groups were compared to explore the high risk factors leading to poor maternal and fetal prognosis. Results the incidence of placental abruption and postpartum hemorrhage in the PE group was significantly higher than that in the N-PE group, which was significantly higher than that in the N-PE group (P < 0.05). The incidence of placental abruption and postpartum hemorrhage in the PE group was significantly higher than that in the N-PE group (P < 0.05), and was significantly higher in the PE group than in the N-PE group. The incidence of fetal intrauterine growth restriction in PE group was higher than that in N-PE group (P < 0.05). The incidence of NICU in PE group was higher than that in N-PE group. The difference was statistically significant (33.7 vs.10.7 + P < 0.001.5) univariate analysis showed that age > 35 years old, the basic blood pressure in the first trimester of pregnancy was severe hypertension. The mean arterial pressure 鈮

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