小剂量硫酸镁、低分子肝素联合治疗早发型重度子痫前期55例疗效观察  

Clinical effect observation of low-dose magnesium sulfate and low-molecular-weight heparin in the treatment of 55 cases of patients with early onset severe preeclampsia

作　　者：廖燕飞 梁议方 潘丽华 LIAO Yanfei;LIANG Yifang;PAN Lihua(Department of Gynecology and Obstetrics,The People′s Hospital of Longhua District,Shenzhen,Guangdong 518109,China)

机构地区：[1]深圳市龙华区人民医院妇产科,广东深圳518109

出　　处：《安徽医药》2020年第10期2067-2070,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨早发型重度子痫前期病人行小剂量硫酸镁、低分子肝素联合治疗,对治疗效及对母婴安全性的影响。方法选取2014年1月至2017年12月于深圳市龙华区人民医院治疗的早发型重度子痫前期病人110例,依据随机数字表法分为对照组和观察组,每组55例。对照组行小剂量硫酸镁治疗方案,观察组行小剂量硫酸镁联合低分子肝素治疗方案。比较两组病人血压及24 h尿蛋白水平变化、凝血功能指标变化、母体并发症发生、妊娠新生儿不良结局发生情况。结果治疗前两组病人血压(141.49±5.64)、(132.61±7.69)、(88.72±4.11)、(81.83±3.10)mmHg、24 h尿蛋白水平(1.89±0.23)、(1.03±0.29)及凝血功能指标(11.32±1.26)s、(11.62±1.35)s、(31.23±5.01)s、(31.60±6.27)s、(5.69±0.55)g/L、(5.63±0.59)g/L、(3.29±0.82)mg/L、(3.26±0.79)mg/L具有可比性,差异无统计学意义(P>0.05)。治疗后两组病人血压、24 h尿蛋白水平及凝血功能指标均有改善,且治疗后观察组病人收缩压(SBP)为(132.61±7.69)mmHg、舒张压(DBP)为(81.83±3.10)mmHg、24 h尿蛋白水平为(1.03±0.29)、凝血酶原时间(PT)为(13.93±1.32)s、活化部分凝血活酶时间(APTT)为(36.59±5.22)s、纤维蛋白原(FIB)为(3.43±0.37)g/L、D-二聚体(DD)为(2.03±0.55)mg/L等凝血功能指标改善更为显著,组间差异有统计学意义(P<0.05)。两组病人母体并发症的发生率为10.91%和41.81%,观察组低于对照组,差异有统计学意义(P<0.05)。两组病人妊娠新生儿不良结局的发生率为12.72%和30.90%,观察组低于对照组,差异有统计学意义(P<0.05)。结论早发型重度子痫前期病人行小剂量硫酸镁、低分子肝素联合治疗,能够有效改善病人血压及凝血功能,改善母婴妊娠结局,具有重要的临床意义。Objective To explore the clinical effect and maternal-infant safety of low-dose magnesium sulfate and low-molecularweight heparin in patients with early onset severe preeclampsia.Methods A total of 110 patients with early onset severe preeclampsia treated in People’s Hospital of Longhua District from January 2014 to December 2017 were selected and divided into control group and observation group according to random number table method,with 55 cases in each group.The control group was treated with low dose magnesium sulfate,while the observation group was treated with low dose magnesium sulfate combined with low molecular weight heparin.The changes of blood pressure,24-hour urinary protein level,coagulation function,maternal complications and adverse outcomes of pregnancy and neonates were compared between the two groups.ResultsThere was no significant difference in blood pressure(141.49±5.64)mmHg,(132.61±7.69)mmHg,(88.72±4.11)mmHg,(81.83±3.10)mmHg,24-hour urinary protein level(1.89±0.23),(1.03±0.29)and coagulation function(11.32±1.26)s,(11.62±1.35)s,(31.23±5.01)s,(31.60±6.27)s,(5.69±0.55)g/L,(5.63±0.59)g/L,(3.29±0.82)mg/L,(3.26±0.79)mg/L between the two groups before treatment(P>0.05).After treatment,blood pressure,24-hour urinary protein level and coagulation function were improved in both groups.After treatment,SBP(132.61+7.69)mmHg,DBP(81.83+3.10)mmHg,24-hour urinary protein level(1.03+0.29)and PT(13.93+1.32)s,APTT(36.59+5.22)s,FIB(3.43+0.37)g/L,DD(2.03+0.55)mg/L and other coagulation function indexes were improved more significantly in the observation group than in the control group.The difference was statistically significant(P<0.05).The incidence of maternal complications in the two groups was 10.91%and 41.81%,which was lower in the observation group than in the control group(P<0.05).The incidence of adverse pregnancy outcomes in the two groups was 12.72%and 30.90%,which was lower in the observation group than in the control group(P<0.05).ConclusionThe combination therapy of low dose magnesiu

关 键 词：子痫前期/药物疗法 肝素 低分子量 硫酸镁 母婴安全 

分 类 号：R714.244[医药卫生—妇产科学]