小剂量阿司匹林联合钙剂在高危人群预防子痫前期的临床体会

Clinical experience of low dose aspirin combined with calcium in the prevention of preeclampsia in high risk pregnant women

目的观察小剂量阿司匹林联合钙剂在高危孕妇人群预防子痫前期的临床效果。方法选择2014年10月~2015年10月在我院围产科门诊具有子痫前期高危因素的孕16~20周160例孕妇,根据孕妇意愿分为观察组和对照组各80例。观察组孕妇从孕14~20周开始口服小剂量的阿司匹林100 mg/d（拜阿司匹林）及乐力氨基酸螯合钙2 g/d,一般至孕36周停药;对照组孕妇不服用任何药物。两组均进行规范的围产保健,同时注意合理饮食,适当休息,适度锻炼;监测血压、体重增长,检测血尿常规、肝肾功能、凝血功能、血清钙等,定时产检监测母胎情况。观察两组孕妇的子痫前期发病率、母婴结局。结果两组孕妇现已追踪随访至分娩结束,观察组子痫前期发病率为6.25%,均为轻度子痫前期,无早发型子痫前期发生,对照组子痫前期发病率25.00%,轻度11.25%,重度7.50%,早发型子痫前期6.25%,差异有统计学意义（P〈0.05）;观察组的孕妇产后出血、胎儿宫内生长受限（FGR）、胎儿宫内窘迫、新生儿窒息发生率明显低于对照组,差异有统计学意义（P〈0.05）。结论高危孕妇在孕早期结束后及早应用小剂量阿司匹林和钙剂预防子痫前期的发生,改善母婴结局,效果显著。

Objective To observe the clinical effect of low dose aspirin combined with calcium in the prevention of preeclampsia in high risk pregnant women.Methods 160 cases of pregnant women with high risk factors of preeclampsia in our perinatal outpatient service from October 2014 to October 2015 were selected and divided into observation group and control group according to the wishes of the pregnant women,with 80 cases in each group.Pregnant women in the observation group started Po dose of 100 mg/d aspirin（aspirin） and ricard calcium amino acid chelate 2 g/d from 14-20 weeks pregnant,generally to 36 gestational weeks,while pregnant women in the control group did not take any drugs.Pregnant women in two groups all were given standardized perinatal care,at the same time pay attention to reasonable diet,suitable rest and moderate exercise.Blood pressure and ponderal growth were monitored,blood routine urine routine,liver and kidney function,blood coagulation function and serum calcium were detected,condition of mother and fetal were regularly antenatal monitored.The incidence of preeclampsia and the maternal and infant outcomes in the two groups were observed.Results Pregnant women in two groups have been followed up to the end of delivery,the incidence of preeclampsia in the observation group was 6.25%,with mild preeclampsia and no early onset preeclampsia.In the control group,the incidence of preeclampsia was 25.00%,mild with 11.25%,severe with 7.50%,early onset preeclampsia with 6.25%,there was significant difference（P 〈0.05）;incidence of postpartum hemorrhage,fetal intrauterine growth restriction（FGR）,fetal distress,neonatal asphyxia in the observation group were significantly lower than those in the control group with statistical significance（P〈0.05）.Conclusion The early application of low-dose aspirin and calcium in the early stage of pregnancy after the end of early pregnancy to prevent occurrence of preeclampsia,improve maternal and neonatal outcomes,the effect is significant.