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目的:用无创血流动力学监测系统研究子痫前期孕妇的血流动力学变化。方法:选择单胎妊娠孕妇418例,分为妊娠期高血压无并发症组、子痫前期无并发症组、子痫前期有并发症组和正常妊娠组。采用无创血流动力学监测系统检测4组孕妇的血流动力学指标。结果:子痫前期两组孕妇的心率(HR)略低,但4组间的HR比较,差异无统计学意义(P>0.05)。正常妊娠组比另3组孕妇平均动脉压(MAP)和外周阻力(SVRI、SVR)明显降低,心脏收缩功能(ACI、VI)明显升高(P<0.05)。子痫前期两组孕妇比正常妊娠组和妊娠期高血压组孕妇的胸液水平(TFC)明显升高(P<0.05)。妊娠期高血压组、子痫前期无并发症组与正常妊娠组3组孕妇的心排出量(CI、CO、SI、SV)比较,差异无统计学意义(P>0.05)。子痫前期有并发症组与子痫前期无并发症组相比,MAP及外周阻力(SVRI、SVR)明显升高(P<0.05),心排出量及心脏收缩功能(CI、CO、SI、SV、ACI、VI)明显降低(P<0.05)。结论:子痫前期时,孕妇的心排出量及心脏收缩功能的降低及外周阻力的明显增高可能是引起妊娠并发症的重要因素,无创血流动力学监测系统可用于指导妊娠期高血压疾病患者的治疗。
Objective: To study the hemodynamic changes of pregnant women with preeclampsia by noninvasive hemodynamic monitoring system. Methods: One hundred and seventy-eight pregnant women of singleton pregnancy were selected and divided into no complication of hypertension during pregnancy, no complications of preeclampsia, complications of preeclampsia and normal pregnancy. Noninvasive hemodynamic monitoring system was used to detect the hemodynamic parameters in 4 pregnant women. Results: The heart rate (HR) of preeclampsia pregnant women was slightly lower, but there was no significant difference in HR among the four groups (P> 0.05). Compared with the other three groups, the mean arterial pressure (MAP) and peripheral vascular resistance (SVRI), SVR and the cardiac contractile function (ACI, VI) in normal pregnancy group were significantly increased (P <0.05). The levels of pleural fluid (TFC) in pregnant women in preeclampsia group were significantly higher than those in normal pregnancy group and gestational hypertension group (P <0.05). There was no significant difference in cardiac output (CI, CO, SI, SV) between the three groups of pregnant women with gestational hypertension, preeclampsia without complications and normal pregnant women (P> 0.05). The levels of MAP and peripheral vascular resistance (SVRI, SVR) in preeclampsia group were significantly higher than those in non-preeclampsia group (P <0.05), cardiac output and cardiac contractile function (CI, CO, SI, SV, ACI, VI) decreased significantly (P <0.05). Conclusions: Pre-eclampsia, pregnant women with decreased cardiac output and cardiac contractility and significantly increased peripheral resistance may be an important factor in pregnancy complications, noninvasive hemodynamic monitoring system can be used to guide patients with gestational hypertension Treatment.