硫酸镁联合低分子肝素治疗早发型子痫前期孕妇的临床效果研究

Research of clinical effect by magnesium sulfate combined with low molecular heparin in the treatment of early-onset preeclampsia

目的评价硫酸镁联合低分子肝素和单纯硫酸镁治疗早发型子痫前期孕妇的临床效果,探讨两种治疗方法对胎儿和新生儿的预后影响。方法 86例早发型子痫前期患者按照随机数字表法分为A、B两组,每组43例。A组患者给予单纯硫酸镁进行治疗,B组患者在A组患者治疗的基础上予以低分子肝素进行治疗。对两组患者治疗前后的收缩压、24 h尿蛋白定量、并发症、胎儿(生理物理评分)和新生儿(阿氏评分、体重及并发症)的预后情况进行观察比较。结果两组患者治疗后的收缩压显著低于治疗前(P<0.05),24 h尿蛋白定量显著高于治疗前(P<0.05);治疗后B组患者的收缩压显著低于A组(P<0.05),治疗后两组胎儿的生物物理评分显著优于治疗前(P<0.05),新生儿的阿氏评分10 min显著高于1 min(P<0.05),而B组新生儿1 min和10 min的阿氏评分显著高于A组(P<0.05),B组新生儿的并发症发生率显著低于A组(25.6%VS 90.7%,P<0.01)。结论硫酸镁联合低分子肝素治疗早发型子痫前期孕妇疗效更加显著,并能显著减少孕妇的并发症发生率,对胎儿和新生儿的预后较好。

Objective To evaluate clinical effect by magnesium sulfate combined with low molecular heparin and single magnesium sulfate in the treatment of early-onset preeclampsia, and to investigate influence of the two methods on prognosis of fetus and newborn. Methods A total of 86 early-onset preeclampsia patients were divided by random number table into group A and group B, with 43 cases in each group. The group A received single magnesium sulfate. The group B received additional low molecular heparin on the basis of treatment measures in group A. Observation and comparison were made on systolic pressure, 24 h urine protein quantitation, complications, prognosis of fetus （biological and physics scores） and newborn （Apgar score, body weight and complications） in the two groups before and after treatment. Results Both groups had much lower systolic pressure after treatment than that before treatment （P〈0.05）, while their 24 h urine protein quantitation was much higher than that before treatment （P〈0.05）. The group B and much lower systolic pressure after treatment than the group A （P〈0.05）. Both groups had obviously better biological and physics scores of fetus after treatment than those before treatment （P〈0.05）, and newborn Apgar score in 10 min was much higher than that in 1 min （P〈0.05）. The group B had higher newborn Apgar score in 1 min and 10 min than the group A （P〈0.05）. The group B also had lower incidence of newborn complications than the group A （25.6%VS 90.7%, P〈0.01）. Conclusion Combination of magnesium sulfate and low molecular heparin provides precise effect in treating early-onset preeclampsia, with significantly reduced incidence of complications in pregnant woman. This method is good for prognosis of fetus and newborn.