妊娠高血压疾病(英)

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1、HypertensionDisordersComplicatingPregnancy妊娠期高血压疾病HypertensiveDisorderscomplicatingPregnancyGestationalHypertensionPreeclampsiaPreeclampsiaSuperimposedonChronicHypertensionChronicHypertensionEclampsiaAGroupofRelatedDiseasesCharacteristicsSystemicsmallarteriesspasmEndothelialcellinjuryHypertens

2、ionProteinuriaMultipleorgansdysfunctionConvulsionMaternalmortalityFetalmortalityGestationalHypertension;ChronichypertensionEclampsiaPreeclampsia;PreeclampsiaSuperimposedonChronicHypertensionHypertensiondisorderscomplicatingpregnancyPathophysiologyCategoryandclinicalmanifestationDiagnosisanddif

3、ferentialdiagnosisManagementandprevention病理生理临床表现诊断治疗EpidemiologyIncidence：6-9%Preeclampsia-eclampsia：70%ChronicHypertension：30%Eclampsia0.5%-1%China1.0%Overseas0.5%ReflectionofmedicallevelThesecondcauseofmaternaldeath(20%)Causeofprematuredelivery（10%）UnknownoriginPathophysiologyBasicpathologi

4、calchangesSpasmofsystemicsmallarteriesVascularendothelialcellinjuryPathophysiologyfluidproteinHypertensionEdemaProteinuriaHemoconcentrationSmallarterialspasmEndothelialcellinjuryMultipleorgansdysfunctionIschemiaEdemamalfunctionSystemicDiseaseBrainHydrocephalusHyperemia/ischemiaThrombosiscerebr

5、alhemorrhagecerebralherniaheadachedazzlenauseavomitHypopsiaretinaldetachmentCorticalblindnessDysesthesiaConfusionofthinkingEclampsiaconvulsioncomabrain：Vasospasmpermeability↑kidneyrenalvasospasmrenalbloodflow↓glomerularfiltrationrate↓pathology：Glomerularexpansionswollenvascularendothelialcellc

6、ellulosedepositionrenocorticalnecrosis——renalirreversibledamageclinicalmanifestation：albuminuriahypoproteinemiarenaldysfunctioncreatinineureanitrogenuricacidoliguriarenalfailureliverhepaticvasospasm;hepaticischemia;hepaticedemaliverenlargement;hepaticdysfunctionelevatedliverenzymejaundicehypop

7、roteinemiacoagulationfunctionchangedsevere：PeriportalnecrosishepaticsubcapsularhematomahepatorrhexisHELLPsymdrome:ElevatedhepaticenzymesDecreasedbloodplateletCardiovascularSystemBloodPressure↑VasospasmVascularResistance↑CardiacLoad↑hear