妊娠高血压孕产妇并发急性肾损伤的危险因素及预防  

Risk Factors and Prevention of Acute Renal Injury in Pregnant Women with Pregnancy Induced Hypertension

作　　者：马戎[1] 窦春江[1] 顾巧玲[1] 鲁琰 慈彩虹 MA Rong;DOU Chun-jiang;GU Qiao-lin;LU Yan;CI Cai-hong(Northwest Minzu University,Lanzhou 730000,China;Maternal and Child Health Hospital of Gansu Province,Lanzhou 730050,China)

机构地区：[1]西北民族大学医学部,甘肃兰州730030 [2]甘肃省妇幼保健医院,甘肃兰州730050

出　　处：《西北民族大学学报（自然科学版）》2022年第4期25-28,共4页Journal of Northwest Minzu University(Natural Science)

基　　金：甘肃省科技计划项目自然科学基金项目(21JR7RA162)。

摘　　要：目的:探究妊娠高血压孕产妇并发急性肾损伤的危险因素及预防措施.方法:选取2018年3月~2018年12月甘肃省妇幼保健院产科收治的98例妊娠期高血压并发急性肾损伤孕产妇作为观察组,收集同期妊娠期高血压未并发急性肾损伤孕产妇100例作为对照组.回顾性收集、比较两组孕产妇基线资料,临床资料,进行多因素分析.结果:98例妊娠高血压并发急性肾损伤孕产妇中有63例(64.29%)孕产妇肾功能得以完全恢复;13例(13.27%)孕产妇部分恢复;22例(22.45%)未恢复孕产妇经透析治疗后17例情况好转,5例死亡.观察组孕产妇出现全身炎症反应综合征(SIRS)、凝血异常和休克的比例显著高于对照组(P<0.05);观察组孕产妇的急性生理与慢性健康(APACHEⅡ)评分、收缩压和舒张压亦显著大于对照组(P<0.05).经多因素Logistic回归分析显示,SIRS、凝血异常、休克、APACHEⅡ以及收缩压和舒张压升高均为妊娠高血压孕产妇并发急性肾损伤的独立危险因素.结论:妊娠高血压并发急性肾损伤孕产妇预后较差,了解其相关危险因素并及时采取措施进行积极干预有助于降低妊娠高血压并发急性肾损伤的发生率,进而改善孕产妇健康情况.Objective To explore the risk factors and prevention measures of acute renal injury in the pregnant women with pregnancy induced hypertension.Methods Between March 2018 to December 2018,98 pregnant women with pregnancy induced hypertension complicated with acute renal injury were selected as the observation group and 100 pregnant women with pregnancy induced hypertension in the same period were collected as the control group.The baseline data, clinical data of the two groups were compared, and multivariate analysis was carried out.Results Among 98 pregnant women with pregnancy induced hypertension complicated with acute renal injury, 63 cases(64.29%) had complete recovery of renal function, 13 cases(13.27%) had partial recovery, 22 cases(22.45%) had no recovery after dialysis treatment, 17 cases(64.29%) died.of the 22 cases(22.45%),17 cases were improved and 5 died.The incidences of systemic inflammatory response syndrome(SIRS),coagulation abnormality and shock in the observation group were significantly higher than those in the control group(P<0.05),and the score of acute physiology and chronic healthⅡ(APACHEⅡ),systolic blood pressure and diastolic blood pressure were significantly higher than those in the control group(P<0.05).Logistic regression analysis of multiple factors showed that SIRS,coagulation abnormality, shock, APACHE Ⅱ,systolic blood pressure and diastolic blood pressure were independent risk factors for pregnant women with pregnancy induced hypertension complicated with acute renal injury.Conclusion The prognosis of pregnant women with pregnancy induced hypertension complicated with acute renal injury is poor, the relevant risk factors and timely measures are taken to intervene to help reduce the incidence of acute renal injury in the pregnancy induced hypertension, and further improve the maternal outcome.

关 键 词：妊娠 高血压 急性肾损伤 全身炎症反应综合征 急性生理与慢性健康评分 

分 类 号：R1-9[医药卫生—公共卫生与预防医学]