MICU综合监治模式对重度子痫前期孕妇预后影响.docVIP

MICU综合监治模式对重度子痫前期孕妇预后影响 　　【摘要】 目的：子痫前期是严重的妊娠并发症，是导致孕产妇以及围产儿死亡的重要原因，具有高级生命支持系统的现代化治疗单元――产科重症监护室（Maternal Intensive Care Unit，MICU）的治疗护理模式能对产科危重症患者进行全面系统的监管以及治疗，分析MICU综合监治模式对母亲以及围产儿预后的影响。方法：回顾性分析2011年01月-2013年01月入住我院产科重度子痫前期孕妇164例，以入住MICU的109例为观察组，以未入住MICU的55例对照组；比较两组患者的入院以及预后情况。结果：观察组中外地转入以及未建孕产妇保健卡的产妇增加，观察组妊娠高血压相关并发症的发生率特别是HELLP综合症的发生率高于对照组，HELLP综合症的发生率组间比较有统计学差异，而两组剖宫产率、产后出血人数以及治愈率比较无统计学差异。分析胎儿出生后1分钟Apger评分低于8分的病例发生率存在组间差异，具有统计学意义。结论：整合地区优势规范系统建立孕产妇保健卡体系以及有效地转诊制度，并且利用现代化治疗单元MICU对重度子痫前期孕产妇全方位的治疗护理病人后，可提高产妇的治愈率，减少严重并发症的发生，但是对围产儿宫内情况无明显改善。 　　【关键词】 子痫前期；重症监护室；并发症；母婴预后 　　【Abstract】 Objective： Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality， and adverse birth outcomes.Very few studies had been published about admission of preeclamptic patients in maternal intensive care units （MICU）.Methods： Files of women who had been diagnosed severe preeclampsia of The maternal and child health hospital of Huai’an between 1 st January 2011 and 31st January 2013 were retrospective analyzed.109 patients were admitted to the MICU， The other was were admitted to the common care unit.Comparison of two groups of patients and prognosis.Results： The preeclamptic related complications of the group who admission to MICU，especially HELLP syndrome，was significantly higher than the control group， the difference of HELLP syndrome’s incidence between groups was statistically significant， and the rate of cesarean section， postpartum hemorrhage and the cure rate is no statistical differences.between groups.And The group who admission to MICU has higher incidence of the newborns who’s 1 min Apger score were under 8，there was statistically significant difference between the groups.Conclusion： The Regular Admission preeclamptic patients to MICU can reduce maternal morbidity，but it didn’t change in neonatal morbidity，Admission preeclamptic patients to MICU gives relevant clues for assessing the quality of obstetrical care 　　【Key words】 pree