206 2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 2015 gestational hypertension 20 140 mmhg1 mmhg = 0. 133 kpa 1-4 90 mmhg 12 2012 160 mmhg 110 mmhg 2012 5 2015 - preeclampsia-eclampsia 1. preeclampsia20 140 mmhg 90 mmhg 6 0. 3 g /24 h / hypertensive disorders of pregnancy 0. 3 + 1 Ⅰ 1 - Ⅱ-1 Ⅱ-2 Ⅱ-3 - Ⅲ severe preeclampsia 2 A 1 160 mmhg B C 110 mmhg2 D 3 E Ⅰ 4 ALT AST 5 > 2. 0 g /24 h 24 h < 400 ml < 17 ml > 106 μmol /L6 7 DOI10. 3877 /cma. j. issn. 2095-3259. 2015. 04. 004 100191 Email zi_yang2005@ 126. com 100026 Emailzhangwy9921@ hotmail. com 20055010721-728. 100 10 9 /L LDH 8 9 10 2. eclamgsia
2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 207 20 4 5 6 140 mmhg 90 mmhg 20 20 12 chronic 2. hypertension with superimposed preeclampsia 1 2 20 20 0. 3 g /24 h + 4 5 20 20 6 7CT MRI 1 7 3 5 min 4 Ⅱ-2A 2 140 mmhg 90 mmhg 140 /90mmHg 30 /15 mmhg 4 h 2 140 mmhg 90 mmhg 160 mmhg 110 mmhg 1. Ⅱ-2B 2 2. 24 h 8 1 2 3 3 2 5 0. 3 g /24 h / 0. 3 + 3. 1. 4.
208 2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 1. 2. 5 ~ 10 mg 3 ~ 4 /d 24 h 60 mg 10 mg 2. 20 mg 1 ~ 2 /d 3. 3. 20 ~ 60 mg 2. 5 ~ 5. 0 mg 4. 160 mmhg 20 ~ 40 mg 3 /d 110 mmhg 1 mg 140 mmhg 90 mmhg 5. α 10 ~ 20 mg 5% 100 ~ 200 ml 130 ~ 155 mmhg 10 μg /min 80 ~ 105 mmhg 130 ~ 139 mmhg 80 ~ 6. 89 mmhg 130 /80 mmhg - Ⅲ-B 5 ~ 10 μg /min 5 ~ 10 20 ~ 50 μg /min MAP10% ~ 25% 24 ~ 48 h 7. 50 mg 4 h Ⅰ-A Ⅰ-A Ⅱ-B 11-14 Ⅰ- Ⅰ-A Ⅱ-3B A 11-14 Ⅰ-A 9 Ⅲ-B 10 Ⅰ-D Ⅱ-2D. ACEI Ⅱ ARB 10 Ⅱ- 2E 1. 50 ~ 150 mg 3 ~ 4 /d 220 mg 50 ~ 100 mg 5% 250 ~ 500 ml 2 ~ 3 /d 20 ~ 40 mg 5% 250 ml 360 mg 10 5% 500 ml 0. 5 ~ 0. 8 μg /kg min Ⅰ-A Ⅰ-C 1. 1 α β 4 ~ 6 g 10% 20 ml 15 ~ 20 min5% 100 ml 20 mg 10 min 1 ~ 2 g /h 80 mg 25%
2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 209 20 ml + 2% 2 ml 24 h 100 mg 50 mg3 25 ~ 30 gⅠ-a 2 1 /3 ~ 1 /2 5% 2. 5 ~ 5. 0 g 6 ~ 12 h 24 h 25 g 17 24 ~ 48 h 3 4 5 ~ 7 d 2. 1. 8 ~ 3. 0 mmol /L 3. 5 mmol /L 1 2 16 /min 3 25 ml /h 600 ml /d 410% 5 ~ 10 min 10% 12 10 ml Ⅰ-A 5 mg 6 mg 1 4 12 mg 1 2 d 2 < 34 Ⅱ-1B 20 8 15 Ⅰ-E 1. 1 16 21 Ⅰ-D 37 Ⅰ-B 2 26 18 22 26 13 Ⅲ-B 1. 2. 5 ~ 5. 0 mg 2 ~ 3 /d 10 mg > 2 min 2. 30 mg 3 /d 24 Ⅰ-C > 34 0. 1 g 3 3. 50 mg 250 ml < 34 1 18-19 28 23 28 ~ 34
210 2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 2. 1 24 h 48 h Ⅰ-E HELLP DIC 24 ~ 48 h 3. 160 mmhg < 100 10 9 /L 4. - 2 24 ~ 48 h 48 h 26-29 3 ~ 6 d 30 Ⅲ-B 150 /100 mmhg 3. Ⅱ-2B 21 ACEI ARB Ⅱ-2B 31 Ⅲ-B 25 4. 1 2 < Ⅲ-I 160/110 mmhgⅡ-2b 3 4 Ⅰ-A 5 Ⅱ-3D 2. 110 mmhg Ⅱ-2B 40 BMI 28 kg /m 2 Ⅲ-C 1. 10 130 mmhg 80 mmhg
2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 211 24 h 0. 3 g + + 1 BMI 18. 5 ~ 25. 0 kg /m 2 < 80 cm 22 Ⅱ-2A Ⅰ-A < 600 mg /d 1 g /d 12 ~ 16 50 ~ 100 mg 28 32 Ⅲ-A 1. 20. 5 μmol /L1. 2 mg /dl LDH 1. < 100 10 9 /L < 150 10 9 /L 1991 Martin 3 HELLP 50 10 9 /L 40% ~ 60% > 50 10 9 /L ~ 100 10 9 /L 20% ~ 40% > 100 10 9 /L ~ 150 10 9 /L 6 12 Ⅱ-2B Ⅱ-2B Ⅱ-2C < 6 g /d HELLP HELLP 2. ALT 40 U/L AST 70 U/L 3. < 100 10 9 /L 20% 33-34 HELLP HELLP 2. LDH HELLP Ⅲ-I 3. HELLP Ⅰ-B
212 2015 11 4 4 Chin J Obstet EmergElectronic Edition November 2015Vol. 4No. 4 HELLP HELLP 4. HELLP DIC PRES 1. 2 mg /dl HELLP HELLP Ⅲ-A Disorders of Pregnancy Working Group. Ⅲ-A 1. executive summaryj 2 4 1> 50 10 9 /L 416-441. Ⅱ-2D 2< 50 10 9 /L Ⅲ-I 3< 50 10 9 /L Ⅲ-I 4< 20 10 9 /L Ⅲ-B Ⅲ-B 2. 1 Ⅱ-2C 2 Ⅲ-B 3 > 75 10 9 /L 35-36 Ⅲ-B 3. HELLP 2005546 517-519. HELLP pregnancy J 1American College of Obstetricians and GynecologistsTask Force Hypertension in Pregnancy. Hypertension in pregnancy. on Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in PregnancyJ. Obstet Gynecol 201312251122-1131. 2Magee LAPels AHelewa Met al. Canadian Hypertensive Diagnosisevaluation and management of the hypertensive disorders of pregnancy. J Obstet Gynaecol Can201436 5 3Visintin CMugglestone MAAlmerie MQet al. Management of hypertensive disorders during pregnancy summary of NICE guidance J. BMJ2010341c2207. 4Lowe SABowyer LLust Ket al. The SOMANZ Guidelines for the Management of Hypertensive Disorders of Pregnancy 2014 J. Aust N Z J Obstet Gynaecol2015551 11-16. 5. 2012 J. 2012 476 476-480. 6Campos-Outcalt D Sr. US Preventive Services Task Forcethe gold standard of evidence-based preventionj. J Fam Pract 7Magee LAHdewa MMomquin JMet al. Diagnosis evaluationand management of the hypertensive disorders of. J Obstet Gynaeeol Can200830 Suppl S1-48. 8Cote AMBrown MALaln Eet al. Diagnostic accuracy of urinary spot proteincreatinine ratio for proteinuria in hypertensive pregnant women systematic review J. BMJ2008336 HELLP 76511003-1006. preventing pre-eclampsia J 241 CD004451. 9Churchill DBeevers GDMeher Set al. Diuretics for. Cochrane Database Syst Rev 2007 10McCoy SBaldwin K. Pharmacotherapeutie options for the treatment of preeelampsia J. Am J Health Syst Pharm2009 66 4 337-344.
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