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目的探讨妊娠合并肾脏疾病患者的围产结局。方法选择2009~2013年四川大学华西第二医院收治的妊娠合并肾脏疾病患者53例作为研究对象。孕期在本院建卡并规律产检的27例为建卡组,孕期在外院就诊且未规律产检的26例为未建卡组,比较两组终止妊娠时孕周、指征、血压、相关生化指标及母儿结局等临床资料。结果未建卡组中因患者肾脏疾病原因需终止妊娠者38.46%(10/26)高于建卡组44.44%(12/27)(P<0.05),其中因病情严重不能继续妊娠且孕周太小选择放弃胎儿而行引产者34.62%(9/26)高于建卡组(0)(P<0.05),而终止妊娠孕周、自然临产率则低于建卡组(P<0.05)。终止妊娠时未建卡组血肌酐、24 h尿蛋白均高于建卡组(P<0.05),血清总蛋白、白蛋白、血红蛋白均低于建卡组(P<0.05)。未建卡组患者并发贫血者及围产儿死亡率高于建卡组(P<0.05)。结论对妊娠合并肾脏疾病患者加强孕期监护,可有效改善母儿结局。
Objective To investigate the perinatal outcome of patients with pregnancy complicated with kidney disease. Methods From 2009 to 2013, 53 patients with pregnancy-related renal disease admitted to the Second West China Hospital of Sichuan University were selected as the research object. Twenty-seven cases were undergone card-building and regular maternity check-ups in our hospital during pregnancy. Among them, 26 cases underwent unplanned maternity and pregnancy check-up in the second trimester of pregnancy were gestational weeks, indications, blood pressure, related biochemistry Indicators and maternal and child outcomes and other clinical data. Results 38.46% (10/26) of the patients in the untreated card group who needed termination of pregnancy due to kidney disease were higher than 44.44% (12/27) in the card-building group (P <0.05), of which the pregnant women were unable to continue pregnancy due to serious illness and gestational age (P <0.05). However, the rate of spontaneous labor termination was lower than that of Jiankai group (P <0.05), and the rate of spontaneous labor termination was significantly lower than that of Jiankai group (34.62%, 9/26) . Serum creatinine, 24 h urinary protein were higher in the card group than in the card group (P <0.05), serum total protein, albumin and hemoglobin were lower than those in the card group (P <0.05). The mortality rate of patients with anemia and perinatal complications in patients without card set was higher than that in card-building group (P <0.05). Conclusions Intensive pregnancy monitoring in patients with pregnancy complicated with kidney disease can effectively improve maternal and infant outcomes.