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目的:研究影响子痫前期及子痫发生HELLP综合征的相关危险因素及妊娠结局,以期指导子痫前期患者预防HELLP综合征发生,改善妊娠结局。方法:回顾性分析2006年2月～2009年8月间新疆医科大学第一附属医院妊娠期高血压疾病患者834例,对符合诊断标准的50例子痫前期轻度、78例子痫前期重度、23例子痫(3组均未发生HELLP综合征)、20例HELLP综合征病例进行分析,比较4组一般临床资料及母儿妊娠结局。结果:①4组民族、家族史、不同产次、来源、产前检查情况比较,差异有统计学意义(P<0.05)。②4组孕妇胎盘早剥、心电图改变、眼底改变、产后出血、急性肾衰发生率差异有统计学意义(P<0.05)。4组围生儿早产、新生儿窒息、胎儿生长受限发生率差异有统计学意义(P<0.05)。结论:①民族、家族史、不同产次、来源、产前检查情况及实验室指标的改变与妊娠期高血压疾病严重程度及HELLP综合征的发生有关。②HELLP综合征孕产妇及围生儿并发证发生率增加。③加强孕期保健,对预防和早期发现HELLP综合征,降低母婴并发证及死亡率有重要意义。
Objective: To study the risk factors and pregnancy outcome of HELLP syndrome affecting preeclampsia and eclampsia and to guide the prevention of HELLP syndrome in preeclampsia patients and improve the pregnancy outcome. Methods: A retrospective analysis of 834 cases of hypertensive disorder complicating pregnancy in the First Affiliated Hospital of Xinjiang Medical University from February 2006 to August 2009 analyzed 50 cases of mild preeclampsia, 78 cases of severe preeclampsia and 23 cases of severe preeclampsia Cases of epilepsy (HELLP syndrome did not occur in all three groups), 20 cases of HELLP syndrome were analyzed, the four groups of general clinical data and maternal and child pregnancy outcomes were compared. Results: There were significant differences in ethnicity, family history, birth time, origin and prenatal examination in group 4 (P <0.05). ② There were significant differences in the incidence of placental abruption, ECG changes, fundus changes, postpartum hemorrhage and acute renal failure among the 4 groups (P <0.05). The prevalence of preterm birth, neonatal asphyxia and fetal growth restriction in 4 groups were statistically significant (P <0.05). Conclusion: (1) The changes of ethnicity, family history, birth time, origin, prenatal examination and laboratory indexes are related to the severity of hypertensive disorders in pregnancy and the occurrence of HELLP syndrome. ② HELLP syndrome maternal and perinatal complications and increased incidence. ③ strengthen the health care during pregnancy, prevention and early detection of HELLP syndrome, reduce the mother and child concurrent certification and mortality are of great significance.