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目的探讨规律产检干预对妊娠期高血压疾病(HDCP)患者血压控制及妊娠结局的影响。方法选择2013年1月-2014年12月在海口市第三人民医院进行产检并分娩的218例HDCP孕产妇为研究对象,将其中接受规律产检干预的120例孕产妇设为观察组,将未接受规律产检干预的98例孕产妇设为对照组,比较两组的血压变化、妊娠期并发症、分娩方式及母婴结局。结果观察组干预后收缩压[(123.32±14.52)mm Hg]和舒张压[(94.48±10.35)mm Hg]均明显低于对照组[(138.76±16.56)mm Hg、(102.45±11.12)mm Hg](t=5.685,P<0.05;t=4.207,P<0.05);观察组妊娠期胎盘早剥、眼底出血、中重度贫血、HELLP综合征等并发症发生率(10.00%)明显低于对照组(19.39%)(χ~2=3.897,P<0.05);观察组剖宫产率(61.67%)明显低于对照组(74.49%)(χ~2=4.039,P<0.05);观察组早产、产后出血、胎儿宫内窘迫、胎儿宫内生长受限、新生儿窒息、围产儿死亡率分别为11.67%、3.33%、9.17%、7.50%、14.17%和0.83%,均明显低于对照组(22.45%、10.20%、18.37%、11.22%、26.53%、6.12%)(P<0.05)。结论规律产检干预有助于控制HDCP患者血压水平,减少妊娠期并发症,提高阴道分娩率,改善妊娠结局。
Objective To investigate the effect of regular antenatal examination on blood pressure control and pregnancy outcomes in patients with hypertensive disorders of pregnancy (HDCP). Methods From January 2013 to December 2014, 218 HDCP pregnant women undergoing childbirth and delivery in Haikou Third People’s Hospital were selected as the study subjects. 120 pregnant women receiving regular genetic examination were selected as observation group, Ninety-eight pregnant women who received regular medical examination and intervention were set as the control group. The changes of blood pressure, complications during pregnancy, mode of delivery and maternal and infant outcomes were compared between the two groups. Results After the intervention, systolic blood pressure (123.32 ± 14.52) mm Hg and diastolic blood pressure (94.48 ± 10.35) mm Hg in the observation group were significantly lower than those in the control group [(138.76 ± 16.56) mm Hg, (102.45 ± 11.12) mm Hg (t = 5.685, P <0.05; t = 4.207, P <0.05). The incidence of complications such as placental abruption, fundus hemorrhage, moderate to severe anemia and HELLP syndrome in the observation group was significantly lower than that of the control (19.39%) (χ ~ 2 = 3.897, P <0.05). The rate of cesarean section in the observation group (61.67%) was significantly lower than that in the control group (74.49%) Preterm birth, postpartum hemorrhage, fetal distress, fetal growth restriction, neonatal asphyxia and perinatal mortality were 11.67%, 3.33%, 9.17%, 7.50%, 14.17% and 0.83%, respectively, which were significantly lower than those of the control (22.45%, 10.20%, 18.37%, 11.22%, 26.53%, 6.12%) (P <0.05). Conclusions Regular antenatal examination intervention can help control the blood pressure of HDCP patients, reduce the complications of pregnancy, improve the vaginal delivery rate and improve the pregnancy outcome.