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目的:探讨重度子痫前期并发腹水的临床特点、孕产期处理及妊娠结局。方法:对该院2006年1月～2010年1月间143例重度子痫前期患者的临床资料进行回顾性分析,根据有无腹水分为腹水组(38例)和无腹水组(105例),比较其临床特点。结果:两组孕妇年龄、产次比较差异无统计学意义(P>0.05);腹水组系统产前检查次数低于无腹水组(P<0.05);腹水组的收缩压和舒张压分别高于无腹水组(P<0.05);腹水组中32例(84.21%)行剖宫产,余6例经阴道分娩;腹水组平均终止妊娠时间为(33±4)周,无腹水组为(36±3)周,差异有统计学意义(P<0.05);两组中总蛋白、白蛋白、白/球比值、血肌酐、24 h尿蛋白差异均有统计学意义(P<0.05);15例孕妇出现严重并发症(39.47%),FGR发生率65%,死胎和新生儿死亡率42.5%,高于无腹水组(P<0.05)。结论:重度子痫前期并发腹水发病早、病情重,血压高,妊娠并发症多,尿蛋白出现早、数值高。应在严格掌握适应证并在严密的监护下,早期、系统、定期的产前检查,合理治疗并适时终止妊娠可改善妊娠结局。
Objective: To investigate the clinical characteristics of severe ascites with ascites, treatment of pregnancy and pregnancy and pregnancy outcomes. Methods: The clinical data of 143 severe preeclampsia patients from January 2006 to January 2010 in our hospital were retrospectively analyzed. According to the presence or absence of ascites, the patients were divided into ascites group (38 cases) and non-ascites group (105 cases) , Compare its clinical features. Results: There was no significant difference in the age and parity between the two groups (P> 0.05). The number of prenatal tests in the ascites group was lower than that in the ascites group (P <0.05). The systolic and diastolic blood pressures 32 cases (84.21%) in ascites group had cesarean section and 6 cases had vaginal delivery. The mean time to termination of pregnancy in ascites group was (33 ± 4) weeks, while that in group without ascites was (36 cases) ± 3) weeks, the difference was statistically significant (P <0.05). There was significant difference in total protein, albumin, white / globule ratio, serum creatinine and 24 h urinary protein between the two groups (P <0.05) Cases of pregnant women with serious complications (39.47%), FGR 65%, stillbirth and neonatal mortality 42.5%, higher than the group without ascites (P <0.05). Conclusions: Severe preeclampsia with ascites early onset, severe illness, high blood pressure, multiple pregnancy complications, early urinary protein, high value. Should be strictly controlled indications and under close supervision, early, systematic, regular prenatal care, rational treatment and timely termination of pregnancy can improve pregnancy outcomes.