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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 investigate the effect of target-directed fluid therapy (GDFT) on maternal and infant in patients with severe preeclampsia (SPE). Methods: Sixty patients with SPE admitted from April to December in 2010 were randomly divided into A and B groups of 30 cases each. The patients in group A received conventional therapy of spasticity, hypotension and sedation. Group B received GDFT on the basis of routine treatment, with central venous pressure (CVP) of 8-12 mmHg, mean arterial pressure (MAP) of 65-90 mmHg, ≥ 0.5 ml / kg.h, central venous oxygen saturation (ScvO2) ≥ 75%. Compare the two groups of maternity, postpartum complications and neonatal outcomes. Results: The incidence of postnatal complications such as heart failure, pulmonary edema, postpartum hemorrhage and disseminated intravascular coagulation (D IC) in group B was significantly lower than those in group A (P <0.05). The fetal development in group B The incidence of complications in preterm and premature infants was also significantly lower than that in group A (P <0.05), while the number of newborns with Apgar scores of 8-10 was significantly higher than that of group A (P <0.05). Conclusion: Individualized GDFT can strictly control the fluid balance of patients with SPE and improve the hypovolemia status of patients, thus reducing the postpartum complications, prolonging the gestational age and improving the neonatal outcome to a certain extent.