慢性高血压合并妊娠164例妊娠结局分析-妇产科学专业毕业论文.docxVIP

I I 慢性高血压合并妊娠 164 例妊娠结局分析 中文摘要 慢性高血压合并妊娠 164 例妊娠结局分析 中文摘要 目的：探讨慢性高血压合并妊娠对围生期结局的影响，以及发生附加子痫前期的 危险因素。 方法：选择苏州大学附属第一医院2011年10月~2013年11月间收治的164例行正规 产检的慢性高血压合并妊娠孕妇为研究对象。根据其是否并发子痫前期分为慢性高血 压合并子痫前期组（PE组，80例）和慢性高血压未并发子痫前期组（N—PE组，84 例）。比较两组患者的并发症和胎儿预后情况，探讨导致母儿不良预后的高危因素。 结果：（1）PE组胎盘早剥和产后出血的发生率明显高于N-PE组（8.8% vs.1.2%， 12.5% vs.2.4%；P＜0.05）。（2）PE组平均分娩孕周小于N-PE组，差异明显（35.3±4.1vs. 38.1±2.4；P＜0.001）；两组＜37周早产、＜34周早产、＜32周早产率分别比较，PE 组高于N-PE组，差异有统计学意义（P＜0.001）。（3）胎儿宫内生长受限发生率PE组 高于N-PE组（26.3% vs.7.1%，P＜0.05）。（4）新生儿转NICU发生率，PE组高于N-PE 组，差异有统计学意义（33.7% vs.10.7%，P＜0.001）。（5）单因素分析：年龄＞35岁、 妊娠初期基础血压为重度高血压、平均动脉压≥114mmHg、肥胖、高血压家族史是 影响慢性高血压合并妊娠患者在正规产检情况下发生附加子痫前期的危险因素；而多 因素logistic回归分析显示：平均动脉压≥114mmHg、肥胖是影响慢性高血压合并妊 娠患者在正规产检情况下并发子痫前期的独立危险因素（ORs:7.018、2.656；95% CIs:2.684-18.354、1.045-6.749）。结论：慢性高血压合并子痫前期患者的母儿病率和 围产儿病死率明显高于未合并子痫前期患者，平均动脉压≥114mmHg、肥胖是慢性 高血压合并妊娠患者在正规产检情况下并发子痫前期的独立因素。 【关键词】慢性高血压；附加型子痫前期；妊娠；母儿结局；危险因素 作 者：俞玉华 指导老师：陈友国 II II 英文摘要 慢性高血压合并妊娠 164 例妊娠结局分析 Pregnancy outcome and the risk factors of superimposed preeclampsia in patients with chronic hypertension: a study of 164 pregnancies in the First Affiliated Hospital of Soochow University Abstract Objective.To analysis effects of chronic hypertension in pregnancy on perinatal outcome, and to explore risk factors of superimposed preeclampsia in patients with chronic hypertension. Methods.Indices of maternal and perinatal morbidity and mortality were determined in 164 women with chronic hypertension who got regularly antenatal visit with data prospectively collected and rigorously validated from October 2011 to November 2013, the First Affiliated Hospital of Soochow University.The 164 women were divided into two groups:chronic hypertention with and without preeclampsia(group PE，80 cases,group N-PE，84 cases ). Maternal and perinatal outcomes of the two groups and the high risk factors for superimposed preeclampsia were analyzed. Results. (1) incidence of placenta abruption and postpartum hemorrhage in group PE were higher than group N-PE（8.8%