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目的:探讨重度子痫前期并发胎盘早剥的临床特征,以便尽早采取干预措施。方法:回顾性分析2005年2月～2009年2月郑州市人民医院产科住院的重度子痫前期患者106例的临床资料。结果:重度子痫前期并发胎盘早剥的发生率为17.92%(19/106)。在胎盘早剥的19例中有3例(15.7%)、未发生胎盘早剥的87例中有62例(71.26%)接受过正规产前检查,两组差异有统计学意义(P<0.05);两组患者收缩压、舒张压波动幅度、合并症(FGR、低蛋白血症、脐血流异常)发生率比较差异有统计学意义(P<0.05)。结论:无规律产前检查、血压波动幅度增加、合并GFR、低蛋白血症、脐血流异常等是重度子痫前期并发胎盘早剥的临床特征。做好产前检查,缓慢平稳降压是防治胎盘早剥的关键。对于合并FGR、低蛋白血症、脐血流异常的重度子痫前期患者应严密监测胎盘早剥的早期征象,并及时干预。
Objective: To investigate the clinical features of severe preeclampsia complicated by placental abruption in order to take early intervention. Methods: The clinical data of 106 patients with severe preeclampsia hospitalized in obstetrics department of Zhengzhou People’s Hospital from February 2005 to February 2009 were retrospectively analyzed. Results: The incidence of placental abruption in severe preeclampsia was 17.92% (19/106). Among the 19 cases of placental abruption, 3 cases (15.7%) and 62 cases (71.26%) of 87 cases without placental abruption had regular prenatal examination, the difference was statistically significant (P <0.05 ). There was significant difference in the incidence of systolic blood pressure, diastolic blood pressure, comorbidity (FGR, hypoproteinemia, cord blood flow abnormality) between the two groups (P <0.05). Conclusion: Unconventional prenatal examination, increased blood pressure fluctuations, combined with GFR, hypoproteinemia, abnormal umbilical cord blood flow are the clinical characteristics of severe preeclampsia complicated with placental abruption. Good prenatal care, slow and steady pressure relief is the key to prevention and treatment of placental abruption. For patients with severe preeclampsia with FGR, hypoproteinemia and abnormal umbilical cord blood flow, early signs of placental abruption should be closely monitored and timely intervention should be performed.