妊娠合并肾脏疾病围产结局分析  

The analysis of perinatal outcomes of pregnancy with renal disease

作　　者：张燕萍[1] 周盛萍 周容[1] 

机构地区：[1]四川大学华西第二医院,四川成都610041

出　　处：《中国计划生育和妇产科》2015年第2期50-53,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的 探讨妊娠合并肾脏疾病患者的围产结局。方法 选择2009~2013年四川大学华西第二医院收治的妊娠合并肾脏疾病患者53例作为研究对象。孕期在本院建卡并规律产检的27例为建卡组,孕期在外院就诊且未规律产检的26例为未建卡组,比较两组终止妊娠时孕周、指征、血压、相关生化指标及母儿结局等临床资料。结果 未建卡组中因患者肾脏疾病原因需终止妊娠者38.46%（10/26）高于建卡组44.44%（12/27）（P〈0.05）,其中因病情严重不能继续妊娠且孕周太小选择放弃胎儿而行引产者34.62%（9/26）高于建卡组（0）（P〈0.05）,而终止妊娠孕周、自然临产率则低于建卡组（P〈0.05）。终止妊娠时未建卡组血肌酐、24 h尿蛋白均高于建卡组（P〈0.05）,血清总蛋白、白蛋白、血红蛋白均低于建卡组（P〈0.05）。未建卡组患者并发贫血者及围产儿死亡率高于建卡组（P〈0.05）。结论 对妊娠合并肾脏疾病患者加强孕期监护,可有效改善母儿结局。Objective To explore the perinatal outcomes of pregnancy with renal disease. Methods 53 pregnant women with renal disease who were hospitalized in West China Second University Hospital of Sichuan University from January 2009 to December 2013 were selected. The patients were divided into two groups according to whether have built maternal care manuals or received regular prenatal examination： regular prenatal examination group included 27 cases, and irregular prenatal examination group included 26 cases. Clinical data when the pregnancy was terminated including gestational age, indications, blood pressure, the related biochemical indexes and perinatal outcomes were compared between the two groups. Results The termination of pregnancy rate associated with the renal disease of the irregular prenatal examination group[ 38.46% （10/26） ] was higher than those of the regular prenatal examination group[44. 44% （ 12/27 ） ] （ P 〈 0. 05 ）. In the former group, the rate of induced labor because of serious condition and too early gestational weeks[34. 62% （9/26） ] was higher than that of the latter group（0） （P 〈0. 05）, while the delivery weeks, natural labor rate of former group were lower than those of the latter group respectively （ P 〈 0. 05 ）. Furthermore, the serum creatinine, 24 hours urine protein of the irregular prenatal examination group were higher than those of the regular prenatal examination group（ P 〈 0. 05 ） ,while the serum total protein, serum albumin, hemoglobin were lower than those of the regular prenatal examination group （P 〈 0. 05 ）. The complications rate of the anemia and the perinatal mortality were higher than those of the regular prenatal examination group（P 〈 0. 05）. Conclusion Strengthening pregnancy care in patients with renal disease can effectively improve the perinatal outcomes.

关 键 词：妊娠合并肾脏疾病 肾功 围产结局 

分 类 号：R714.2[医药卫生—妇产科学]