目的 探讨分析未行规律产检的轻度与重度子痫前期孕妇的临床特征,分析发生重度子痫前期的危险因素.方法 选取于2010年8月至2016年7月治疗并分娩的非规律产检的患者178例.剔除非规律产检的患者中慢性高血压并发子痫前期的患者20例,剩余158例非规律产检的子痫前期患者为研究对象.分析患者的临床资料和产前检查情况,分析子痫前期临床发病的危险因素.结果 158例患者中,重度子痫前期的患者147例,早发型68例(46.26%),晚发型79例(53.74%).轻度子痫前期患者11例,早发型1例(9.09%),晚发型9例(90.91%).重度子痫前期患者中,早发型患者所占比率46.26%明显高于轻度子痫前期患者9.09%,差异有统计学意义(χ2=5.747,P=0.017).产检医院等级越低,重度子痫前期所占比率越高,三级医院重度子痫前期患者3例(75.00%),二级医院重度子痫前期患者90例(93.75%),一级医院重度子痫前期患者48例(94.12%).两组患者临床发病风险因素比较,高龄、初孕、初产、辅助生育、肥胖、多胎妊娠和子痫前期病史等比较差异无统计学意义(P>0.05).重度子痫前期患者的首次产检孕周和实际产检次数与轻度子痫前期患者比较,差异无统计学意义(Z=1.375,0.933,P>0.05).重度子痫前期患者获得诊断前产检间隔时间明显长于轻度子痫前期患者;妊娠20周后,检查次数少于轻度子痫前期患者,差异有统计学意义(Z=7.033,10.828,P0.05).重度子痫前期患者诊断子痫前期孕周和入三级医院孕周明显早于轻度子痫前期患者,间隔时间长于轻度子痫前期患者,差异有统计学意义(Z=9.550,7.273,6.311,P0.05).The first prenatal examination and actual inspection times of the patients with severe preeclampsia had no significant difference with the patients with mild preeclampsia (Z=1.375, 0.933, P>0.05).Compared with mild PE patients, the prenatal care interval for PE diagnosis in severe PE patients was longer, the frequency of prenatal care after 20 gestational weeks was less, the difference was significant different (Z=7.033, 10.828, P<0.05).After 20 weeks of gestation, the prenatal start time and interval of prenatal care of the two groups, the difference was significant different (Z=0.018, 2.052, P<0.05).The gestational week of PE diagnosis and referral to grade 3 hospitals were earlier, and the interval between PE diagnosis and referral was longer, the difference was significant different (Z=9.550, 7.273, 6.311, P<0.05).The frequency of prenatal care after 20 gestational weeks was an independent risk factor for severe PE (P=0.001).Conclusion The occurrence of severe preeclampsia in pregnant women without regular prenatal care are related with the number of times of hospital examination, prenatal care after 20 gestational weeks, and the time of referral to the grade three hospital.
展开▼
