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目的观察综合干预措施对妊娠期高血压疾病的预防作用。方法选择2015年4月—2016年12月产检的孕妇1670例,随机分为干预组与对照组,各835例。对照组行常规产检,给予常规孕产期指导;干预组给予饮食管理与体重管理。对比两组分娩时妊娠期高血压疾病发生率及血压水平;对比两组分娩时血清钙、锌、叶酸、维生素B12水平;对比两组妊娠并发症发生情况、分娩方式。计量资料比较采用t检验,计数资料比较采用χ~2检验。P<0.05为差异有统计学意义。结果分娩时观察组收缩压、舒张压[(115.09±10.37)、(78.37±6.64)mm Hg(1 mm Hg=0.133 kPa)]低于对照组[(129.34±9.80)、(85.04±6.19)mm Hg],比较差异有统计学意义(均P<0.05)。观察组血钙、锌、叶酸、维生素B12水平[(2.29±2.21)mmol/L、(0.79±0.10)μg/ml、(26.12±3.37)nmol/L、(376.05±7.72)pmol/L]均高于对照组[(1.92±0.14)mmol/L、(0.67±0.08)μg/ml、(22.97±3.05)nmol/L、(369.15±6.37)pmol/L],比较差异有统计学意义(均P<0.05)。观察组妊娠期高血压疾病、产后出血、早产、胎儿宫内窘迫、新生儿窒息发生率及剖宫产率(1.80%、5.87%、2.04%、1.80%、2.04%、31.74%)均低于对照组(10.06%、15.21%、8.38%、8.74%、5.87%、59.88%),比较差异有统计学意义(均P<0.05)。结论综合干预措施可有效降低孕妇妊娠期高血压疾病的发生率,改善妊娠结局。
Objective To observe the preventive effect of comprehensive intervention on hypertensive disorder complicating pregnancy. Methods 1670 pregnant women were selected from April 2015 to December 2016. They were randomly divided into intervention group and control group, with 835 cases each. Control group routine inspection, giving regular guidance of pregnancy; intervention group to give diet and weight management. The incidence of hypertensive disorder complicating pregnancy and blood pressure were compared between the two groups. Serum levels of calcium, zinc, folic acid and vitamin B12 were compared between the two groups during childbirth. The incidence of pregnancy complications and delivery mode were compared between the two groups. Measurement data were compared using t test, count data were compared using χ ~ 2 test. P <0.05 for the difference was statistically significant. Results Compared with the control group [(129.34 ± 9.80), (85.04 ± 6.19) mm], the systolic blood pressure and diastolic blood pressure in the observation group during labor (115.09 ± 10.37 and 78.37 ± 6.64 mm Hg, Hg], the difference was statistically significant (all P <0.05). The levels of serum calcium, zinc, folic acid and vitamin B12 in the observation group were significantly higher than those in the control group (2.29 ± 2.21 mmol / L, 0.79 ± 0.10 μg / ml, 26.12 ± 3.37 nmol / L, 376.05 ± 7.72 pmol / L, (1.92 ± 0.14) mmol / L, (0.67 ± 0.08) μg / ml, (22.97 ± 3.05) nmol / L and (369.15 ± 6.37) pmol / L respectively), all of which were statistically significant P <0.05). The incidence of gestational hypertension, postpartum hemorrhage, preterm delivery, fetal distress, neonatal asphyxia and cesarean section rate in the observation group were all lower than those in the control group (1.80%, 5.87%, 2.04%, 1.80%, 2.04%, 31.74% The control group (10.06%, 15.21%, 8.38%, 8.74%, 5.87%, 59.88%), the difference was statistically significant (all P <0.05). Conclusion Comprehensive interventions can effectively reduce the incidence of pregnancy-induced hypertension and improve pregnancy outcome.