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目的:探讨重度先兆子痫并发HELLP综合征对母儿结局的影响。方法:以重度先兆子痫101例(单胎妊娠91例,双胎10例)为研究对象,将其中重度先兆子痫并发HELLP综合征26例(单胎妊娠22例,双胎4例)中22例单胎妊娠并发HELLP综合征病患为HELLP组,重度先兆子痫对照综合征75例(单胎妊娠69例,双胎6例)中69例单胎妊娠对照综合征病患为对照组,回顾性分析HELLP组和对照组孕妇的母儿结局。结果:HELLP组中最高舒张压、确诊孕周和终止妊娠孕周分别为(107.41±20.17)mm Hg、(32.17±4.80)周和(32.34±5.02)周,对照组分别为(97.39±13.49)mm Hg、(35.12±3.67)周和(34.80±4.02)周,两组差异均有统计学意义(P<0.05)。HELLP组期待治疗时间(1.42±2.71)天与对照组(2.51±3.52)天比较差异无统计学意义(P>0.05),HELLP组剖宫产率59.09%与对照组82.61%比较差异有统计学意义(P<0.05)。两组尿蛋白、使用硫酸镁剂量差异均无统计学意义(P>0.05)。HELLP组使用静脉降压药物、多浆膜腔积液、眼底痉挛渗出及低氧血症发生率分别为31.82%、63.64%、45.45%和18.18%,对照组分别为4.35%、10.14%、13.04%和4.35%,两组比较差异均有统计学意义(P<0.05)。HELLP组新生儿体质量(1 751.80±1 027.13)g与对照组(2 474.20±946.61)g比较差异有统计学意义(P<0.05)。HELLP组孕产妇死亡1例,死儿丢失9例;对照组未发生孕妇死亡,发生死儿丢失4例。结论:重度先兆子痫一旦并发HELLP综合征则表示病情危重,因HELLP综合征的发病孕周早将可能阻碍胎盘功能发挥,从而引发胎儿发育受限甚至发生死胎,其可严重影响母儿结局,而采取积极的治疗干预可争取较好的母儿结局。
Objective: To investigate the impact of severe preeclampsia with HELLP syndrome on maternal and child outcomes. Methods: A total of 101 severe preeclampsia cases (91 singletonic pregnancies and 10 twin pregnancies) were enrolled in this study. Twenty-six patients with severe preeclampsia complicated by HELLP syndrome (22 cases of singleton pregnancy and 4 cases of twins) Twenty-two singleton pregnancies complicated with HELLP syndrome were HELLP group. Among the 75 patients with severe preeclampsia control syndrome (69 cases of singleton and 6 cases of twin), 69 cases of singleton pregnancy control syndrome were control group , Retrospective analysis of pregnant women and children HELLP group and control group outcome. Results: The highest diastolic blood pressure, the gestational weeks diagnosed in gestational weeks and terminated pregnancies in the HELLP group were (107.41 ± 20.17) mm Hg, (32.17 ± 4.80) weeks and (32.34 ± 5.02) weeks respectively, and those in the control group were (97.39 ± 13.49) mm Hg, (35.12 ± 3.67) weeks and (34.80 ± 4.02) weeks, the differences between the two groups were statistically significant (P <0.05). HELLP group expected treatment time (1.42 ± 2.71) days and the control group (2.51 ± 3.52) days was no significant difference (P> 0.05), HELLP group 59.09% compared with the control group 82.61% difference was statistically significant Significance (P <0.05). Urinary protein in both groups, the use of magnesium sulfate dose difference was not statistically significant (P> 0.05). HELLP group using intravenous antihypertensive drugs, multiple serous effusions, fundus spasm exudate and hypoxemia incidence rates were 31.82%, 63.64%, 45.45% and 18.18%, respectively, the control group were 4.35%, 10.14% 13.04% and 4.35%, respectively, with significant difference between the two groups (P <0.05). The body weight of newborns in HELLP group was significantly higher than that of control group (2471.8 ± 1027.13 g) and 2447.20 ± 946.61 g (P <0.05). HELLP group maternal death in 1 case, missing 9 cases of death; control group did not occur in pregnant women, the loss of 4 children died. Conclusions: Severe pre-eclampsia, once complicated with HELLP syndrome, is considered as critically ill. The onset of HELLP syndrome may prevent placental dysfunction as early as possible and lead to fetal development restriction and even stillbirth, which may seriously affect maternal and infant outcomes. And take active treatment intervention can strive for a better maternal and child outcomes.