妊娠高血压综合征诊断标准合理性的探讨  

Study on diagnostic criterion of pregnancy induced hypertension

作　　者：苏莉[1] 黄醒华[1] 翟桂荣[1] 阮炎[1] 刘洪滨[1] 

机构地区：[1]首都医科大学附属北京妇产医院产科,100006

出　　处：《中华妇产科杂志》2003年第9期530-533,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　探讨我国现行的妊娠高血压综合征 (妊高征 )诊断标准的合理性。方法　回顾性分析我院收治的 916例妊高征患者的临床资料 ,分别按我国现行的妊高征诊断标准和国外的妊高征诊断标准重新分类 ,并对两种标准分类的孕产妇和围产儿结局进行分析。结果　 ( 1)两种诊断标准的妊高征分类构成比比较 :按我国标准 ,轻、中、重度妊高征的构成比分别是 46 6% ( 4 2 7例 )、18 4% ( 169例 )、3 4 9% ( 3 2 0例 ) ;按国外标准 ,轻、中、重度妊高征的构成比分别是 47 6% ( 4 3 6例 )、14 3 % ( 13 1例 )、3 8 1% ( 3 4 9例 )。两者比较 ,差异有显著性 (P <0 0 5)。两种诊断标准分类在轻度妊高征的符合率为 85 0 % ;重度妊高征的符合率为 93 8% ;而中度妊高征的符合率仅 40 2 %。 ( 2 )孕产妇结局 :早产、产后出血和胎盘早剥的发生率 ,按我国标准比较 ,差异均有显著性 (P <0 0 5) ;按国外标准比较 ,差异也有显著性 (P <0 0 5) ;但两种诊断标准对应组间比较 ,差异无显著性 (P >0 0 5)。( 3 )围产儿结局 :胎儿生长受限 (FGR)、新生儿窒息和围产儿死亡发生率及新生儿病率 ,按我国标准比较 ,差异有显著性 (P <0 0 5) ;按国外标准比较 ,差异也有显著性 (P <0 0 5) ;但以上 3项指标在两种诊断标准间比较 ,差异?Objective To study the rationality of the current diagnostic criterion of pregnancy induced hypertension (PIH) in China's Mainland Methods To analytically review the 916 cases of PIH in our hospital,reclassify them using both the current domestic diagnostic criteria and the William Obstetrics′ criteria, then compare and analyze perinatal and maternal outcomes from the two standards Results (1)Maternal outcomes :comparison result of the occurrences among three groups of premature birth, postpartum haemorrhage and placental abruption according to domestic classification had significant difference ( P <0 05) And it′s the same result according to foreign classification ( P <0 05) But the occurrences within three groups of premature birth, postpartum haemorrhage and placental abruption between domestic and foreign classifications showed no significant difference( P >0 05) (2)Perinatal outcomes: Comparison results of the occurrences among three groups of fetal growth restriction,asphyxia neonatorum and perinatal fetal and neonatal death incidence according to domestic classification had significant difference( P <0 05) And it′s the same result according to foreign classification( P <0 05) But the occurrences within three groups of fetal growth restriction,asphyxia neonatorum and perinatal fetal death and neonatal incidence showed no significant difference( P >0 05) (3)The constituent ratio of mild,moderate,severe PIH according to domestic classifications was 46 6%,18 4%,34 9% respectively The constituent ratio of gestationgal hypertision,mild preeclampsia and severe preeclampsia according to foreign classifications was 47 6%,14 3%,38 1% There were significant differences between domestic and foreign constituent ratio( P <0 05) If you compare the results from these two diagnostic classifications, with mild PIH,the accordant rate was 85 0%; with severe PIH,the rate was 93 8%; but it′s only 40 2% with moderate PIH Conclusions

关 键 词：妊娠高血压综合征 诊断标准 合理性 回顾性分析 

分 类 号：R714.246[医药卫生—妇产科学]