妊娠高血压合并OSAHS患者应用CPAP治疗对母儿结果的影响

发布时间：2018-04-13 18:24

本文选题：高血压 + 妊娠性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年04期

【摘要】：目的:探讨妊娠高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者应用持续气道正压通气(CPAP)治疗对母儿结果的影响,为临床治疗提供依据。方法:选择经PSG检查确诊为OSAHS的患者117例,将能耐受坚持CPAP治疗者设为干预组(70例),未用CPAP治疗者设为对照组(47例)。对照组只接受常规药物治疗;而干预组除常规药物治疗外,同时接受CPAP治疗,并在随后的产前保健和产后过程中,记录妊娠高血压合并OSAHS孕妇的母儿结果。结果:与对照组比较,轻度、中度OSAHS孕妇中剖宫产和产后出血差异均无统计学意义(P0.05);重度OSAHS孕妇中剖宫产、产后出血差异均有统计学意义(P0.05或P0.01)。与对照组比较,轻度OSAHS孕妇中新生儿窒息、胎儿生长受限、胎儿窘迫差异均无统计学意义(P0.05);中度OSAHS孕妇中胎儿生长受限、胎儿窘迫差异有统计学意义(P0.05);重度OSAHS孕妇中新生儿窒息、胎儿生长受限、胎儿窘迫差异均有统计学意义(P0.05或P0.01)。结论:妊娠高血压妇女尤其是有OSAHS高危因素者,应详细询问病史并注意是否有OSAHS的症状,一旦怀疑OSAHS,需行PSG检查。特别对于重度OSAHS的妊娠高血压患者强烈建议分娩前及早应用CPAP治疗,CPAP是一种安全有效的治疗妊娠高血压合并OSAHS的方法。
[Abstract]:Objective: to investigate the effect of continuous positive airway pressure (CPAP) therapy on maternal and fetal outcomes in patients with pregnancy hypertension complicated with obstructive sleep apnea hypopnea syndrome (OSAHS).Methods: 117 patients with OSAHS diagnosed by PSG were divided into intervention group (70 cases) and control group (47 cases).The control group only received routine drug therapy, while the intervention group received CPAP treatment in addition to routine drug therapy, and recorded the maternal and fetal results of pregnant women with OSAHS during the subsequent prenatal care and postpartum process.Results: compared with the control group, there was no significant difference in cesarean section and postpartum hemorrhage between mild and moderate OSAHS pregnant women, while there was no significant difference between severe OSAHS pregnant women with cesarean section and postpartum hemorrhage (P 0.05 or P 0.01).Compared with the control group, there was no significant difference in neonatal asphyxia, fetal growth restriction and fetal distress between mild OSAHS pregnant women and moderate OSAHS pregnant women.There were significant differences in fetal distress (P 0.05), neonatal asphyxia, fetal growth restriction and fetal distress (P 0.05 or P 0.01) in severe OSAHS pregnant women.Conclusion: pregnant hypertensive women, especially those with high risk factors of OSAHS, should inquire about their history and pay attention to the symptoms of OSAHS. Once suspected, PSG should be performed.Especially for severe OSAHS patients with pregnancy-induced hypertension, it is suggested that the early use of CPAP before delivery is a safe and effective method for the treatment of pregnancy-induced hypertension with OSAHS.
【作者单位】：荣成市人民医院耳鼻咽喉头颈外科;烟台市毓璜顶医院耳鼻咽喉头颈外科;荣成市人民医院妇产科;
【分类号】：R766;R714.246

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