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目的:分析无严重并发症重度子痫前期(s PE)的终止妊娠影响因素和现状,以寻求不同病况个体的最佳终止妊娠的时机和母胎利益平衡的最大化。方法:选择莱芜市人民医院妇产科于2011年6月至2014年6月间入院诊断为不伴有严重并发症的s PE住院病患220例为研究对象,根据终止妊娠孕周长短分为<26周组、26~28周组、28~30周组、30~32周组、32~34周组、34~36周组和≥36周组,研究各组终止妊娠的影响因素。结果:终止妊娠的指征在<26周终止者以孕周为考虑因素者占33.3%(2/3)。26~28周组中社会因素是独立影响因素(P<0.001)。在28~30周组的主要影响因素有单纯尿蛋白因素、发生严重并发症、难以控制的高血压及胎心监护异常。在30~32周组影响终止妊娠的主要因素为出现严重并发症。32~34周组影响终止妊娠的主要因素为尿蛋白因素、难以控制的高血压及胎心监护异常。34~36周组以孕周为考虑因素。≥36周后终止妊娠指征以孕周为考虑因素占68.7%。结论:1影响入院时无严重并发症s PE终止妊娠的指征性因素较多,社会因素也是重要影响因素之一,值得提起重视。2存在着单纯以尿蛋白定量或单纯孕周因素为终止指征者。单纯以尿蛋白定量或单纯孕周因素为终止妊娠指征是否适宜有待更深入研究。
OBJECTIVE: To analyze the influential factors and current status of termination of pregnancy in severe preeclampsia (sPE) without serious complications, in order to find out the optimal timing of termination of pregnancy and the maximization of the balance of maternal benefits in individuals with different conditions. Methods: Obstetrics and Gynecology of Laiwu People’s Hospital was selected from 220 patients admitted to our hospital from June 2011 to June 2014 for s PE inpatients without serious complications as study subjects. According to the length of the gestational weeks of termination of pregnancy, <26weeks, 26-28weeks, 28-30weeks, 30-32weeks, 32-34weeks, 34-36weeks, and> 36weeks. The influencing factors of termination of pregnancy in each group were studied. RESULTS: Indications for termination of pregnancy accounted for 33.3% (2/3) of those gestational weeks at <26 weeks of termination. Social factors in the 26-28 weeks group were independent influencing factors (P <0.001). The main influencing factors in 28-30 weeks group were simple urinary protein factors, serious complications, uncontrollable hypertension and abnormal fetal heart rate monitoring. The main factor affecting the termination of pregnancy in the 30- to 32-week group was serious complications. The main factors affecting the termination of pregnancy in the 32- to 34-week group were urinary protein factors, uncontrolled hypertension and abnormal fetal heart rate monitoring. Weeks 34 to 36 were considered as gestational age. The indication of termination of pregnancy after 36 weeks accounted for 68.7% of the gestational age. Conclusions: 1 There is no significant complication when hospitalized. There are many indication factors of PE termination of pregnancy, and social factors are also one of the important influencing factors. It is worth to pay attention. 2 there is simply to quantitative urinary protein or simple gestational factors for termination of indications. Purely urinary protein or simple gestational age factors for termination of pregnancy indications suitable for further study.