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目的:观察比较不同类型妊娠期高血压疾病的围生结局。方法:选择妊娠期高血压疾病221例,根据病情程度分为轻度子痫前期组(A组)106例、重度子痫前期组(B组)70例、妊娠合并慢性高血压组(C组)36例和妊娠期高血压组(D组)9例。比较各组早产和分娩情况,以及围生期并发症发生情况和围生儿结局等指标。结果:(1)A组、B组、C组和D组早产率分别为15.1%、64.3%、16.7%、0.0%,剖宫产率分别为69.8%、98.6%、77.8%、44.4%;B组早产率及剖宫产率均非常显著高于其他3组(P<0.01),A组与C组比较差异不显著(P>0.05);A组、C组剖宫产率显著高于D组(P<0.05)。(2)B组视网膜病变、胎盘早剥、胸腔积液、急性肾损伤、低蛋白血症和脐血流异常的发生率,均非常显著高于其他3组(P<0.01);A组、C组、D组间比较,均差异不显著(P>0.05)。(3)B组足月低体质量儿发生率非常显著高于A组和D组(P<0.01),与C组比较差异不显著(P>0.05)。各组间胎儿窘迫、新生儿窒息发生率比较,差异不显著(P>0.05)。结论:不同类型妊娠期高血压疾病的围生结局不同,病情越严重,对围生结局影响越大,应给予积极治疗和严密监护。
Objective: To observe and compare the perinatal outcome of different types of gestational hypertension. Methods: 221 cases of hypertensive disorder complicating pregnancy were selected and divided into mild preeclampsia group (group A) (106 cases), severe preeclampsia group (group B) (70 cases), pregnancy complicated with chronic hypertension group (group C) ) 36 cases and gestational hypertension group (D group) 9 cases. Preterm labor and delivery were compared between groups, as well as the incidence of perinatal complications and perinatal outcome and other indicators. Results: (1) The preterm birth rates of group A, group B, group C and group D were 15.1%, 64.3%, 16.7% and 0.0% respectively. The rates of cesarean section were 69.8%, 98.6%, 77.8% and 44.4% respectively. The rates of preterm birth and cesarean section in group B were significantly higher than those in the other three groups (P <0.01), while there was no significant difference between group A and group C (P> 0.05). The cesarean section rates in groups A and C were significantly higher D group (P <0.05). (2) The incidence of retinopathy, placental abruption, pleural effusion, acute kidney injury, hypoproteinemia and umbilical blood flow abnormalities in group B were significantly higher than those in the other three groups (P <0.01) There was no significant difference between group C and group D (P> 0.05). (3) The incidence of full-term low birth weight children in group B was significantly higher than that in group A and group D (P <0.01), but not significantly different from that in group C (P> 0.05). There was no significant difference in the incidence of fetal distress and neonatal asphyxia between groups (P> 0.05). CONCLUSION: Different types of gestational hypertension have different perinatal outcomes. The more severe the disease, the greater the impact on the perinatal outcome, should be given active treatment and intensive care.