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相關文獻
- 淺談姙娠高血壓
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題名 | 淺談姙娠高血壓=Management of Hypertensive Disorders in Pregnancy |
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作者 | 陳湘婷; 林家伊; | 書刊名 | 藥學雜誌 |
卷期 | 31:3=124 2015.09[民104.09] |
頁次 | 頁104-108 |
分類號 | 417.346 |
關鍵詞 | 妊娠高血壓; 子癲前症; 子癲症; HELLP症候群; Gestational hypertension; Preeclampsia; Eclampsia; HELLP syndrome; |
語文 | 中文(Chinese) |
中文摘要 | 高血壓的疾患占孕婦的5-10%,為孕婦死亡的前三大主因之一,而引發死亡的原 因,通常是因為高血壓合併子癲前症或子癲症,其發生率占孕婦的3.9%。妊娠中的 高血壓,指收縮壓大於140 mmHg 或舒張壓大於90 mmHg,或妊娠後期之收縮壓比早 期高30 mmHg 或舒張壓升高15 mmHg。對於輕微的妊娠高血壓病人可在家中臥床休 息,服用降血壓藥物控制血壓。降血壓的藥物包含 methyldopa、labetalol、nifedipine 及 hydralazine,一旦血壓持續上升或有嚴重子癲前症的症狀出現時,則需要住院觀察 及治療。嚴重的子癲前症和子癲症的病人,可以使用靜脈輸注硫酸鎂 (MgSO4) 來預 防或控制痙攣的發生。硫酸鎂的作用在於抗痙攣而非降低血壓。使用硫酸鎂時,應要 特別注意病人的肌腱反射 (deep tendon reflexes, DTR)、呼吸速率以及尿量,並且時常 監測血清中的鎂離子濃度,以避免中毒發生。 |
英文摘要 | Hypertensive disorders are the most common medical complication of pregnancies, with an incidence of 5–10%, and a common cause of maternal mortality all over the world. Most cause of death is patients diagnosed with gestational hypertension will subsequently develop into pre-eclampsia, or severe features. In addition, these pregnancies may result in preterm delivery, fetal intrauterine growth restriction, and placental abruption. Hypertension is defined as a systolic blood pressure (BP) ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg or both. In the absence of strong evidence supporting the use of antihypertensive therapy for mild-to-moderate hypertension during pregnancy, initiation of pharmacological therapy is not recommend unless BP approaches severe hypertention range. The choice of antihypertensive agents include methyldopa、labetalol、nifedipine and hydralazine. Patients should receive an intravenous magnesium sulfate for eclamptic seizures or seizure prophylaxis. Because of the side effects, we recommend to monitor the serum magnesium concentration, DTR, respiration and urine output when using magnesium sulfate. |
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