目标导向液体治疗对重度子痫前期母儿预后的影响  

Effect of goal-directed fluid therapy on prognosis of pregnant women with severe preeclampsia and their neonates

作　　者：陈瑞玲[1] 王晓晖[1] 许剑[1] 骆智宇 付清梅 梁小勤[1] 

机构地区：[1]深圳市宝安区人民医院妇产科,518101

出　　处：《中国妇幼保健》2011年第16期2532-2534,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨目标导向液体治疗(GDFT)对重度子痫前期(SPE)患者母儿的影响。方法:收集2010年4～12月住院的SPE患者60例,随机分为A、B两组各30例。A组给予解痉、降压及镇静的常规治疗;B组在常规治疗的基础上给予GDFT,使中心静脉压(CVP)8～12 mmHg,平均动脉压(MAP)65～90 mmHg,尿量≥0.5 m l/kg.h,中心静脉血氧饱和度(ScvO2)≥75%。比较两组产妇产时、产后并发症及新生儿结局。结果:B组产妇的产时、产后并发症如心力衰竭、肺水肿、产后出血和弥散性血管内凝血(D IC)的发生率比A组显著降低(P<0.05);B组胎儿发育受限、早产儿及早产儿并发症发生率亦明显低于A组(P<0.05),而新生儿Apgar评分8～10分的例数则显著多于A组(P<0.05)。结论:个体化的GDFT能够严格控制SPE患者的液体平衡,改善患者低血容量状态,从而在一定程度上减少产时、产后并发症,延长胎龄,改善新生儿结局。Objective：To explore the effect of goal-directed fluid therapy（GDFT） on prognosis of pregnant women with severe preeclampsia and their neonates.Methods：60 patients with severe preeclampsia who hospitalized in the hospital from April to December in 2010 were collected,then they were divided into A group and B group,30 patients in each group.The patients in A group were treated with conventional treatment including spasmolysis,depressurization and sedative;and the patients in B group were treated with GDFT on the basis of conventional treatment,central venous pressure（CVP） maintained at 8～12 mmHg,mean arterial pressure（MAP） maintained at 65～90 mmHg,urine volume maintained at least 0.5 ml/kg·h and central venous oxygen（ScvO2） maintained at least 75%.The complications during and after delivery of pregnant women and the outcomes of their neonates in the two groups were compared.Results：The incidences of complications during and after delivery including heart failure,pulmonary edema,postpartum hemorrhage and disseminated intravascular coagulation（DIC） in B group were significantly lower than those in A group（P〈0.05）.The incidences of fetal growth restriction and premature infants and the incidences of complications of premature infants in B group were significantly lower than those in A group（P〈0.05）,but the number of neonates whose Apgar scores were 8～10 in B group was more than that in A group（P〈0.05）.Conclusion：The individualized GDFT can strictly control the fluid equilibrium in patients with severe preeclampsia,improve hypovolemia,reduce the complications during and after delivery to some extent,prolong the fetal age and improve the neonatal outcomes.

关 键 词：重度子痫前期 目标导向液体治疗 低血容量 

分 类 号：R714.24[医药卫生—妇产科学]