小剂量肝素治疗妊娠合并艾森曼格综合征的临床价值

The clinical value of low-dose heparin therapy for pregnancy with eisenmenger syndrome

目的探讨小剂量肝素治疗妊娠合并艾森曼格综合征的临床价值。方法选择60例,分为两组,各30例,对照组采用对症支持处理,观察组则在对照组的基础上每天静滴5000U肝素,比较两组患者分娩前24h凝血功能,以及围生期出现肺栓塞和脑栓塞情况。结果分娩前24h观察组FiB显著低于对照组(P<0.05),观察组围生期出现肺栓塞和脑栓塞的比率均显著低于对照组(P<0.05),观察组顺产11例,剖宫产13例,流产6例,产前心衰者9例,产后心衰者15例,死亡者6例,对照组观察组顺产6例,剖宫产7例,流产17例,发生产前心衰者7例,产后心衰者11例,死亡者12例。结论小剂量肝素静脉滴注,能显著降低患者体内纤维蛋白原水平,减少肺栓塞和脑梗死等严重并发症发生率。

Objective To investigate the clinical value of low-dose heparin therapy for pregnancy with eisenmenger syndrome. Methods 60 cases were divided into two groups, each 30 cases, the control group were used symptomatic and supportive treatment, the observation group were on the basis of the control group and used intravenous heparin 5000 units per day,then 24 hours before childbirth coagulation the two groups with delivery ratio and perinatal period of pulmonary embolism and cerebral embolism case were compared. Results FiB in the observation group was significantly lower than control group （P＆lt;0.05）,the observation group with perinatal pulmonary embolism and cerebral embolism were significantly lower than control group （P＆lt;0.05）,the observation group spontaneous delivery was 11 cases, cesarean section was 13 cases, six cases with abortion, prenatal heart failure was 9 cases,postpartum heart failure was 15 cases and death was 6 cases, the control group spontaneous delivery was 6 cases,cesarean section was 7cases, 17 cases with abortion, prenatal heart failure was 7 cases,postpartum heart failure was 11 cases and death was 12 cases. Conclusion Low dose heparin intravenously can significantly reduce fibrinogen levels in patients and reduce the incidence of serious complications such as pulmonary embolism and cerebral infarction.