| 廖燕飞,梁议方,潘丽华.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[J].安徽医药,2020,24(10):2067-2070. |
| 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 |
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| DOI：10.3969/j.issn.1009?6469.2020.10.038 |
| 中文关键词: 子痫前期/药物疗法 肝素，低分子量 硫酸镁 母婴安全 |
| 英文关键词: Pre?Eclampsia/ drug therapy Heparin,low?molecular?weight Magnesium sulphate Maternal?infant safety |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| Objective To explore the clinical effect and maternal?infant safety of low?dose magnesium sulfate and low?molecular?weight heparin in patients with early onset severe preeclampsia.Methods A total of 110 patients with early onset severe pre?eclampsia treated in People′s Hospital of Longhua District from January 2014 to December 2017 were selected and divided intocontrol 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 withlow molecular weight heparin.The changes of blood pressure，24?hour urinary protein level，coagulation function，maternal complica? tions and adverse outcomes of pregnancy and neonates were compared between the two groups.Results There 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 significant?ly in the observation group than in the control group.The difference was statistically significant(P＜0.05).The incidence of mater? nal 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 observa? tion group than in the control group(P＜0.05).Conclusion The combination therapy of low dose magnesium sulfate and low mo?lecular weight heparin for early onset severe preeclampsia can effectively improve blood pressure and coagulation function and ma?ternal and infant pregnancy outcomes，which has important clinical significance. |
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