硫酸镁在子痫前期治疗中的争议及其不良反应  

Confused Problem of Magnesium Sulfate in the Treatment of Preeclampsia and Its Adverse Effects

作　　者：赵丽霞 王小青[2] ZHAO Li-xia;WANG Xiao-qing(Changzhi Medical College,Changzhi 046000,Shanxi Province,China;Department of Obstetrics,The Third People's Hospital of Datong,Datong 037008,Shanxi Province,China)

机构地区：[1]长治医学院,山西省长治市046000 [2]大同市第三人民医院产科

出　　处：《国际妇产科学杂志》2024年第4期448-452,共5页Journal of International Obstetrics and Gynecology

摘　　要：子痫前期是妊娠期导致母儿不良妊娠结局的特发性疾病。解痉是治疗子痫前期的重要且有效手段,硫酸镁是一线解痉药物。目前硫酸镁在治疗子痫前期中仍存在着一些争议,包括:非重度子痫前期是否用硫酸镁治疗,既往研究不推荐应用硫酸镁预防子痫发作,但近年研究认为,子痫前期患者应酌情使用硫酸镁预防子痫;关于产前硫酸镁治疗子痫前期的使用疗程问题,近年研究认为硫酸镁的使用疗程应该小于24 h;产后硫酸镁预防子痫发作,现有的研究支持产后硫酸镁应用可以小于24 h,甚至不使用;硫酸镁使用后相关的不良反应,包括增加母体产后出血风险,引起母体高镁血症、低钙血症,导致新生儿低钙血症、影响骨钙沉积和新生儿高钾血症等。Preeclampsia is an idiopathic disease during pregnancy that leads to adverse pregnancy outcomes for both mothers and children.Spasmolysis is an important and effective means to treat preeclampsia,and magnesium sulfate is the firstline spasmodic drug.At present,there are still some controversies about magnesium sulfate in the treatment of preeclampsia,including:whether magnesium sulfate is used for non-severe preeclampsia,magnesium sulfate is not recommended to prevent seizures in previous studies.However,recent studies believe that magnesium sulfate should be used to prevent eclampsia in patients with preeclampsia.Regarding the question of the course of prenatal magnesium sulfate for preeclampsia,several studies in recent years have concluded that the course of magnesium sulfate should be less than 24 h.Postpartum magnesium sulfate can prevent seizures,and existing studies support that postpartum magnesium sulfate application can be less than 24 h or even not used.Adverse reactions associated with the use of magnesium sulfate,including increased maternal postpartum haemorrhage risk,maternal hypermagnesemia,hypocalcemia,neonatal hypocalcemia and bone calcium deposition,neonatal hyperkalemia,etc.

关 键 词：硫酸镁 先兆子痫 子痫 药物相关性副作用和不良反应 高镁血症 治疗 

分 类 号：R714.244[医药卫生—妇产科学]