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目的从临床实践方面进一步探讨我国最近制定的妊娠期高血压疾病重度子疒间前期诊断分类标准的临床意义。方法收集我院1992年1月至2003年12月诊治的妊娠期高血压疾病493例,其中1992年1月至1997年12月6年内按重度妊高征诊断标准诊断的病例73例(A组),1998年1月至2003年12月6年内按重度子疒间前期诊断标准判断的病例119例(B组)。分析493例按我国过去沿用的妊高征分类标准诊断的各类妊高征患者中有关脏器损害的临床症状及体征的发生率,并比较A、B两组不同标准判断的重度子疒间前期的母婴预后。结果重度妊高征中各项有关脏器损害临床表现的发生率较高,中度妊高征亦有一定的发生率,但较重度妊高征低。B组低体重儿、新生儿窒息、严重并发症及子疒间的发生率均较A组低,两组比较差异有显著性意义,两组围生儿死亡率比较差异无统计学意义。结论我国目前参照世界卫生组织通用标准提出的妊娠期高血压疾病重度子疒间前期分类诊断标准体现了有关脏器损害的程度,有一定客观依据和临床价值。包括了过去旧的分类诊断方法中的重度妊高征和部分中度妊高征患者,有利于妊娠期高血压疾病的防治,减少不良妊娠结局。
Objective To further explore the clinical significance of the classification standard of pre-diagnosis in severe gestational hypertension in pregnancy. Methods A total of 493 cases of hypertensive disorder complicating pregnancy were collected from January 1992 to December 2003 in our hospital. Among them, 73 cases were diagnosed according to the diagnostic criteria of severe pregnancy-induced hypertension in the period from January 1992 to December 1997 ), January 1998 to December 2003 within 6 years according to the diagnostic criteria for severe preeclampsia 119 cases (B group). Analysis of 493 cases of pregnancy-induced hypertension according to our classification of the past diagnosis of various types of pregnancy-induced hypertension in patients with clinical symptoms and signs of organ damage and compare A, B two groups of different criteria to determine the severity of sub-room Pre-maternal and infant prognosis. Results The incidence of clinical manifestations of various organ-related injuries in severe PIH was high, moderate PIH also had a certain incidence, but the incidence of severe PIH was low. B group of low birth weight infants, neonatal asphyxia, severe complications and the incidence of subfascia were lower than that of A group, the difference between the two groups was significant, the difference between the two groups was no significant difference in perinatal mortality. Conclusions Our current diagnostic criteria for early diagnosis of HIE in severe gestational hypertension refer to the WHO General Criteria, which has some objective evidence and clinical value. Including the past classification of the old diagnosis of severe pregnancy-induced hypertension and some patients with moderate pregnancy-induced hypertension is conducive to the prevention and treatment of hypertensive disorders during pregnancy, reduce adverse pregnancy outcomes.