|
|
|
| Effect of Postoperative Fluid Balance on Prognosis of Patients with Severe Preeclampsia |
| FENG Li-yuan, WANG Zhen-hui |
| Department of Obstetrics and Gynecology, The Maternal and Child Health Care Hospital of Hunan Province, Changsha Hunan 410008 |
|
|
|
|
Abstract 【Objective】To retrospectively analyze the effects of different fluid balance on the prognosis and hospital stay of patients with severe preeclampsia. 【Methods】A total of 683 patients with severe preeclampsia who underwent cesarean section in our hospital was selected. The water inflow and outflow for 24 hours were recorded in the first 3 days after operation. They were divided into three groups according to different fluid balance after operation. Group A was positive fluid balance (n=134, fluid inflow and outflow within 3 days after operation >200 mL), and group B was fluid balance (n=189, fluid inflow and outflow within 3 days after operation -200~200 mL), Group C was the negative fluid balance group (n=360, the amount of fluid in and out within 3 days after operation was ≤-1000 mL). The heart rate, blood oxygen saturation, maximum systolic blood pressure, maximum diastolic blood pressure, brain natriuretic peptide (BNP), urinary specific gravity and the length of hospital stay in each group were compared 3 days after operation, and the negative rate of urinary protein, blood pressure and BNP return to normal 42 days after delivery were compared. 【Results】The blood oxygen saturation of the group A and the group B was lower than that of the group C (P<0.05), but there was no significant difference between the group A and the group B (P>0.05); The heart rate, maximum systolic blood pressure, maximum diastolic blood pressure and hospital stay in the group A and the group B were significantly higher than those in the group C (P<0.05), but there was no significant difference between the group A and the group B (P>0.05); There was no significant difference in BNP level and urinary specific gravity among the three groups (all P>0.05). At 42 days postpartum, the negative rate of urinary protein in group A was lower than that in the group C (P<0.05), and the return to normal rate of blood pressure in the group A was lower than that in the group B and the group C (P<0.05), but there was no significant difference between the group B and the group C (P>0.05); BNP returned to normal in the three groups, and there was no significant difference (P>0.05). 【Conclusion】The negative balance of fluid inflow and outflow after severe preeclampsia can improve the patient's blood pressure, increase the blood oxygen saturation, reduce the length of hospital stay, and effectively improve the patient's prognosis.
|
|
Received: 19 April 2021
|
|
|
|
|
|
[1] 伍绍文, 李光辉, 邹丽颖,等. 重度子痫前期分娩安全性的多中心研究[J].中国实用妇科与产科杂志, 2018, 34(2):190-194.
[2] PETERSON E, CRAIGO S, AND HOUSE M. Risk factors for postpartum antihypertensive medication requirement in severe preeclampsia[J].Hypertens Pregnancy,2010,29(3): 350-356.
[3] TAN L K, SWIET M D. The management of postpartum hypertension[J].BJOG,2002,109(7): 733-736.
[4] 田辉. 围术期临床干预对子痫前期剖宫产患者并发急性肺水肿的影响[J].医学临床研究, 2016,33(2): 1873-1875.
[5] VEENA P, PERIVELA L, RAGHAVAN S S. Furosemide in postpartum management of severe preeclampsia: A randomized controlled trial[J].Hypertens Pregnancy,2017,36(1): 84-89.
[6] 谢幸, 孔北华. 妇产科学[M].第9版.北京:人民卫生出版社, 2018.
[7] 李燕君,俄洛吉. 晚发型重度子痫前期患者外周血 Treg/Th17 细胞亚群含量和妊娠结局分析[J].医学临床研究, 2019,36(10): 379-381.
[8] CHURCHILL D, BEEVERS G D, MEHER S, et al. Diuretics for preventing pre-eclampsia[J].Cochrane Database Syst Rev,2007(1): CD004451.
[9] 杨孜, 张为远. 《妊娠期高血压疾病诊治指南(2020)》解读[J].中华妇产科杂志, 2020, 55(6):425-432.
[10] 杨嘉琳, 徐仲, 龙振鸿. 血管外肺水指数变化和液体平衡对重度子痫前期患者预后的影响研究[J].中国医学创新, 2017, 14(5): 27-30.
[11] 杨杰孚, 李莹莹. 从《中国心力衰竭诊断和治疗指南2018》看容量管理[J].临床药物治疗杂志, 2019,17(10): 10-14.
[12] 王岚, 何明珊, 葛莉宾,等.重度子痫前期患者剖宫产术后短期应用呋塞米干预治疗的临床研究[J].世界最新医学信息文摘(电子版), 2019,19(60): 1-2. |
| [1] |
. [J]. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 147-149. |
|
|
|
|
2022, Vol. 39 
