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妊娠期高血压疾病的处理难点和困惑——妊娠期高血压疾病诊治指南(2020)解读

Difficulties and Confusion Concerning the Management of Hypertensive Disorders in Pregnancy--Interpretation of the Guidelines for the Diagnosis and Treatment of Hypertensive Disorders in Pregnancy (2020)

  • 摘要: 妊娠期高血压疾病是一个临床表现多样化的疾病。本文将对《妊娠期高血压疾病诊治指南(2020)》进行解读,并结合临床工作实践,探讨妊娠期高血压疾病的处理难点和困惑。降血压治疗最为重要,维持稳定的目标血压可以减少脏器功能损害,并有利于胎儿生长。硫酸镁的应用要注意适应证和禁忌证。尿蛋白阳性者需要关注低蛋白血症问题。动态评估母亲重要脏器功能和胎儿生长发育及宫内安危,掌握恰当的终止妊娠时机,才能保障母儿安全。重视母亲高危因素,早期预测和预防可以减少发病率和减轻疾病严重程度。

     

    Abstract: Hypertensive disorder in pregnancy is a disease with diverse clinical manifestations. Herein, we provided interpretations for “The Guidelines for the Diagnosis and Treatment of Hypertensive Disorders in Pregnancy in China (2020 Edition)” and discussed the difficulties and confusion encountered in the management of hypertensive disorders in pregnancy in combination with clinical practice. Lowering blood pressure is the most important treatment and maintaining a stable target blood pressure can reduce damage to organ functions and is beneficial to fetal growth. When applying magnesium sulfate, attention should be paid to the indications and contraindications. Attention should be paid to hypoproteinemia in patients tested positive for proteinuria. There should be dynamic evaluation of the functions of maternal vital organs, fetal growth and development, fetal well-being and intrauterine safety, and determination of the appropriate timing of the termination of pregnancy, so as to ensure maternal and fetal safety. Attention should be paid to maternal high-risk factors, if early prediction and prevention are to be accomplished in order to reduce the incidence and severity of the disease.

     

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