早发型子痫前期中西医联合期待治疗临床观察

Clinical observation of early-onset preeclampsia magnesium in traditional chinese and western medicine combined with expectant treatment

目的研究早发型子痫前期硫酸镁联合丹参及低分子肝素期待治疗效果和安全性。方法选择浙江诸暨市妇幼保健院2011年10月—2013年10月72例早发型子痫前期患者,采用数字表随机法分为2组,对照组36例患者采用常规硫酸镁治疗,研究组36例患者在对照组基础上联合丹参及低分子肝素期待治疗,对2组产妇情况包括孕周延长时间、凝血结果、产后出血发生率,新生儿情况包括脐血流S/D比值、新生儿Apgar评分等指标及不良反应进行比较。结果治疗后研究组血浆黏度比、D-二聚体、平均动脉压(MAP)明显低于对照组,研究组孕期延长时间明显长于对照组,研究组新生儿Apagr评分≥7分的占77.78%,新生儿体重≥1500 g的占61.11%,明显高于对照组,新生儿死亡率低于对照组,2组比较差异具有统计学意义(P<0.05)。2组产妇产后出血等并发症、分娩结局、新生儿并发症比较差异无统计学意义(P>0.05)。观察组36例孕妇治疗后凝血功能、肝肾功能及血小板指标均无明显变化,与治疗前比较差异无统计学意义(P>0.05)。结论早发型子痫前期硫酸镁联合丹参及低分子肝素期待治疗可延长妊娠时间,明显提高新生儿生理指标,且对凝血、肝、肾功能无不良影响,具有良好的有效性和安全性。

Objective To study the effect of early-onset preeclampsia magnesium sulfate in combination with salvia milti- orrhiza and expect therapeutic effect and safety of low molecular heparin. Methods From October 2011 to October 2013, 72 early-onset preeclampsia patients were enrolled and randomly divided into two groups by using digital table, control group 36 cases were treated by conventional magnesium sulfate treatment,36 patients in observation on the basis of con- ventional magnesium sulfate treatment, combining salvia miltiorrbiza and low molecular heparin treatment, the two groups of maternal include gestational time delay, the results of the blood coagulation, the incidence of postpartum hemorrhage, neonatal cases including umbilical cord blood flow S/D ratio and neonatal Apgar score indexes and adverse reaction were compared. Results After treatment,the team plasma viscosity.ratio,D-dimer,MAP were significantly lower than those of the control group, the team obviously prolong pregnancy time was longer than that of the control group, the group at the newborn Apagr score of 7 or more（77.78% ）, neonatal weight of 1500 g or accounted for 61.11%, significantly higher than the control group, neonatal mortality rate was lower than the control group, and comparing the two groups had signifi- cant difference （P 〈 0. 05 ）. Two groups of maternal postpartum complications such as bleeding, delivery end, there was no significant difference compared neonatal complications （ P 〉 0.05 ）. Observation group of 36 cases of pregnant women blood coagulation function after treatment, liver and kidney function and platelet indexes had no obvious changes, com- pared with before treatment had no significant differences （ P 〉 0.05 ）. Conclusion Magnesium sulfate combined salvia mihiorrhiza early-onset preeclampsia and low molecular heparin treatment can prolong pregnancy, improve neonatal physi- ological indexes, and with no harm to the blood coagulation, liver and kidney function, had the good efficacy and safety.