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目的:探讨高原地区妊娠早发型重度子痫前期与妊娠并发症危险因素的关系,及其对妊娠结局的影响。方法:采用回顾性调查方法,调查2009年12月—2012年12月青海高原地区早发型重度子痫前期的发生率;比较早发型和晚发型重度子痫前期患者发生并发症的风险、常见并发症的种类和对妊娠结局的影响。结果:通过调查发现,早发型重度子痫前期占在全部妊娠高血压疾病的13.61%;早发型重度子痫前期患者发生并发症的人数为20人,占76.9%;发生并发症的次数为33次,为126.9%,晚发型165人,发生妊娠并发症的人次数为63人,占38.18%;两组发生并发症的发生率经统计学对比有显著性差异(2=13.65,P=0.000)。早发型重度子痫前期患者26例中,早产13例,占所有并发症的39.4%,列第一位,其他依次是产后出血、胎儿宫内发育迟缓、死胎、胎儿宫内窘迫。晚发型与早发型并发症顺位不同,并发症发生最多的是产后出血,其他依次是胎儿宫内窘迫、胎儿发育迟缓、早产。死胎仅发生于早发型患者中。结论:高原地区妊娠早发型重度子痫前期患者的发生率与全国相似;早发型重度子痫前期并发症的发生率明显高于晚发型重度子痫前期患者;早产是早发型患者最大的威胁;早发型重度子痫前期可能造成妊娠不良结局。
Objective: To investigate the relationship between early pregnancy severe preeclampsia and risk factors of pregnancy complications and its effect on pregnancy outcome in high altitude areas. Methods: A retrospective survey was conducted to investigate the incidence of early-onset severe preeclampsia in the Qinghai Plateau from December 2009 to December 2012. The risk of complications in patients with early-onset and late-onset severe preeclampsia was compared. Common complications The type of disease and the impact on pregnancy outcomes. Results: According to the survey, early-onset severe preeclampsia accounted for 13.61% of all cases of pregnancy-induced hypertension; in early-onset severe preeclampsia, the number of complications was 20, accounting for 76.9%; the number of complications was 33 (126.9%), late-onset type (165) and pregnancy complications (63.3%, 38.18%). There was a significant difference in the incidence of complications between the two groups (2 = 13.65, P = 0.000). Of the 26 patients with early-onset severe preeclampsia, 13 were premature, accounting for 39.4% of all complications, followed by postpartum hemorrhage, fetal intrauterine growth retardation, stillbirth, and fetal distress. Late onset and early onset complications in the same order, the largest complication occurred postpartum hemorrhage, followed by fetal distress, fetal retardation, premature delivery. Stillbirth occurs only in early-onset patients. Conclusions: The incidence of early pregnancy severe preeclampsia is similar to that of the whole country. The incidence of early onset severe preeclampsia is significantly higher than that of late onset severe preeclampsia. Premature labor is the biggest threat to early onset patients. Early onset severe preeclampsia may result in adverse pregnancy outcomes.