复方丹参注射液和低分子肝素治疗早发型重度子痫前期的围产结局分析

Analysis of the Perinatal Outcome of the Early Severe Preeclampsia Women Treated with Compound Danshen Injection and Low Molecular Weight Heparin

目的探讨早发型重度子痫前期患者应用复方丹参注射液、低分子肝素抗凝治疗对母婴结局的影响。方法对2008年10月—2011年1月收治的95例早发型重度子痫前期患者进行回顾性分析。共计有硫酸镁组40例,应用硫酸镁常规治疗;复方丹参组23例,常规治疗加复方丹参注射液;低分子肝素组32例,常规治疗加低分子肝素。收集各组患者的一般情况,分析两种抗凝药物对分娩情况、产后出血量、终止妊娠的原因及母体并发症的影响。结果 (1)硫酸镁组终止妊娠孕周平均为(31.7±1.9)周,新生儿平均体重为(1450.5±402.3)g;复方丹参组分别为(33.0±1.8)周及(1582.2±332.5)g;低分子肝素组分别为(32.8±1.7)周及(1590.0±340.1)g;各组间分娩孕周及新生儿体重比较差异无统计学意义。(2)3组均以剖宫产终止妊娠为主,手术的主要原因依次为母亲并发症、血压控制不理想及胎儿窘迫等。(3)3组并发症依次为肾功能衰竭(12例);胎盘早剥(9例);溶血、肝酶升高及血小板减少(hemolysis,elevated liver enzymes,and low platelets syndrome,HELLP)综合征(8例)。硫酸镁组发生并发症16例(40.0%),复方丹参组12例(52.2%),低分子肝素组15例(46.9%),各组间比较差异无统计学意义。结论低分子肝素及复方丹参有助于提高重度子痫前期患者的治疗效果且不增加药物的不良反应,且似有延长孕周的作用。

Objective To study the effects of using Compound Danshen Injection （CDI） and low molecular weight heparin （LMWH） on early severe preeclampsia women. Methods Retrospective analysis was carried out in 95 patients with early severe preeelampsia from October 2008 to January 2011. They were assigned to 3 groups based on anticoagulant drugs. The routine therapy of magnesium sulfate （MgSO4） was given to the MgSO4 group （40 cases） ; the MgSO4 ＋CDI was given to those in the CDI group （23 cases）, the MgSO4 ＋ LMWH group was given to those in the LMWH group （32 cases）. The general data of all patients were collected to analyze their effects on labor, postpartum hemorrhage, reasons for terminating the pregnancy, and maternal complications. Results （1） The average gestational week （weeks） of terminating the pregnancy was 31.7± 1.9 in the MgSO4 group, 33.0± 1.8 in the CDI group, and 32.8 ± 1.7 in the LMWH group. The average weight of newborn babies （g） was 1 450.5 ±402.3 in the MgSO4 group, 1 582.2±332.5 in the CDI group, and 1 590.0 ±340. 1 in the LMWH group. There was no obviously difference in the average gestational weeks or the average weight of newborn babies among the three groups. （2） The way of terminating the pregnancy was uterine-incision delivery. The main reasons for operation were sequenced as maternal complications, unsatisfied control of the blood pressure, and fetal distress. （3） The maternal complications in the three groups were sequenced as renal failure （12 cases）, placental abruption （9 cases）, hemolysis, increased liver enzymes and low platelet （HELLP） syn- drome （8 cases）. Sixteen （40.0%） had complications in the MgSO4 group, 12 （52.2%） in the CDI group, and 15 （46.9%） in the LMWH group. No statistic difference existed among the 3 groups. Conclusions LMWH and CDI were helpful to improving the therapeutic effects of severe preeclampsia patients. They did not increase adverse drug reactions. They seemingly had effects on prolonging the gestational week.