高压氧联合低分子肝素钠治疗早发型重度子痫前期48例疗效分析  

Efficacy of hyperbaric oxygen combined with low molecular weight heparin sodium in the treatment of early-onset severe preeclampsia in 48 cases

作　　者：王通奎 孙秀明 王晓丽[1] 王俊虎[1] 吕颖欣 孙亚琪 刘召防 Wang Tongkui;Sun Xiuming;Wang Xiaoli;Wang Junhu;Lyu Yingxin;Sun Yaqi;Liu Zhaofang(Department of Obstetrical,The Second People’s Hospital of Liaocheng,Liaocheng 252600,China;Department of Otolaryngology,The Second People’s Hospital of Liaocheng,Liaocheng 252600,China)

机构地区：[1]聊城市第二人民医院产科,聊城252600 [2]聊城市第二人民医院耳鼻喉科,聊城252600

出　　处：《中华航海医学与高气压医学杂志》2025年第3期277-281,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合低分子肝素钠治疗早发型重度子痫前期(EOSP)的临床疗效及对血浆凝血指标的影响。方法选取2020年2月至2023年6月聊城市第二人民医院产科收治的97例EOSP孕妇作为研究对象,按照随机数字表法分为对照组(n=49)和观察组(n=48)。对照组孕妇予以低分子肝素钠治疗;观察组孕妇在对照组治疗的基础上联合高压氧治疗。采用电子血压仪检测2组孕妇治疗前后收缩压(SBP)及舒张压(DBP)的变化,并统计临床疗效。采用黄嘌呤氧化酶法检测2组孕妇治疗前后血清谷胱甘肽过氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)的水平,采用硫代巴比妥酸法测定血清脂质过氧化物(LPO)的水平。采用凝固法和免疫比浊法测定2组孕妇血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)的水平。随访至孕妇分娩后,统计2组孕妇不良妊娠结局发生情况。结果治疗后观察组总有效率(93.75%)明显高于对照组(77.55%),差异有统计学意义(χ^(2)=5.152,P=0.013)。与治疗前相比,2组孕妇治疗后DBP、SBP均明显降低,且治疗后观察组均明显低于对照组(均P<0.05)。与治疗前相比,2组孕妇治疗后血清GSH-Px、SOD水平均明显提高,LPO水平明显降低;且治疗后观察组孕妇血清GSH-Px、SOD水平均明显高于对照组,LPO水平明显低于对照组(均P<0.01)。与治疗前相比,2组孕妇治疗后PT、APTT、TT均明显延长,FIB水平明显降低;且治疗后观察组PT、APTT、TT均明显长于对照组,FIB水平明显低于对照组(均P<0.01)。观察组不良妊娠结局发生率(10.42%)明显低于对照组(32.65%),差异有统计学意义(χ^(2)=7.068,P=0.008)。结论高压氧联合低分子肝素钠治疗EOSP疗效确切,能有效降低孕妇的氧化应激反应,改善凝血功能,减少不良妊娠结局的发生。Objective To analyze the efficacy of low molecular weight heparin sodium combined with hyperbaric oxygen in the treatment of early-onset severe preeclampsia(EOSP),and its effect on plasma coagulation indicators.Methods A total of 97 pregnancy women with EOSP admitted to the Second People’s Hospital of Liaocheng from February 2020 to June 2023 were retrospectively analyzed.Based on the random number table method,they were divided into a control group(n=49)and an observation group(n=48).The control group was treated with low molecular weight heparin sodium,while the observation group was additionally treated with hyperbaric oxygen on the basis of the treatments of the control group.The systolic blood pressure(SBP)and diastolic blood pressure(DBP)of two groups of pregnant women were measured before and after treatment using an electronic blood pressure monitor,and clinical efficacy was statistically evaluated.The levels of serum glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)were measured before and after treatment in the two groups using the xanthine oxidase method,while lipid peroxide(LPO)levels were determined using the thiobarbituric acid method.The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)levels in the plasma of the two groups of pregnant women were measured using coagulation and immunoturbidimetric methods.The incidence of adverse pregnancy outcomes was statistically analyzed by following up with the two groups of pregnant women until after delivery.Results After treatment,the total effective rate in the observation group(93.75%)was significantly higher than that in the control group(77.55%),with the difference being statistically significant(χ^(2)=50152,P=0.013).Compared with before treatment,both groups of pregnant women showed significant reductions in DBP and SBP after treatment,and the levels in the observation group were significantly lower than those in the control group(all P<0.01).The serum levels of GSH-Px and SOD significant

关 键 词：早发型重度子痫前期 高压氧 低分子肝素钠 氧化应激 凝血功能 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]