低分子肝素钙联合阿司匹林治疗早发型重度子痫前期的临床效果研究

Clinical effect study of low molecular weight heparin calcium combined with aspirin in the treatment of early onset severe preeclampsia

目的探讨低分子肝素钙联合小剂量阿司匹林在早发型重度子痫前期患者中的临床效果及对血压改善、妊娠结局的影响。方法选择2015-01-01～2016-12-31西安市中心医院收治的早发型重度子痫前期患者80例作为对象,随机数字法分为对照组(40例)和观察组(40例)。对照组采用常规休息、镇静、解痉、有指征地降压、利尿、促胎肺成熟等综合治疗,观察组在对照组基础上配合低分子肝素钙、阿司匹林治疗。采用CA7000全自动血液分析仪测定两组治疗前、后纤维蛋白原(FIB)、凝血活酶时间(APTT)、凝血酶原时间(PT)及血小板计数水平;采用血压测定仪测定两组治疗前、后收缩压、舒张压水平;采用自动生化仪检测两组治疗前、后血尿氮素(BUN)、24 h尿蛋白定量(24hUP)、血尿酸(UA)、血肌酐(Scr)水平;记录并统计两组治疗后胎儿窘迫、新生儿死亡、胎盘早剥、产后出血、剖宫产及胎儿生长受限发生率,比较两组临床疗效及对妊娠结局的影响。结果观察组和对照组治疗后FIB、APTT、PT、BUN、24hUP、UA、Scr、血小板、收缩压、舒张压之间比较,以及同组间治疗前后比较,均有统计学意义(P <0. 05),观察组治疗后胎儿窘迫、新生儿死亡、胎盘早剥、产后出血及胎儿生长受限发生率,均低于对照组(P <0. 05)。结论将低分子肝素钙联合阿司匹林用于早发型重度子痫前期患者中有助于改善凝血因子、血压及肾功能水平,提高妊娠结局,值得推广应用。

Objective To investigate the clinical effect of low molecular weight heparin combined with low-dose aspirin in patients with early onset severe preeclampsia and its effect on improvement of blood pressure and pregnancy outcomes.Methods Eighty pregnant women with early onset severe preeclampsia were selected from January2015to December2016.The patients were divided into control group(n=40)and observation group(n=40)by random number method.The control group was treated with conventional rest,sedation,spasm,decompression,diuresis,and fetal lung maturation.The observation group was treated with low molecular weight heparin calcium and aspirin on the basis of the control group.Before and after treatment,fibrinogen(FIB),thromboplastin time(APTT)prothrombin time(PT)and platelet count were measured by CA7000automatic hematology analyzer.Blood pressure was measured before treatment,systolic blood pressure(SBP)and diastolic blood pressure(DBP).The levels of BUN,24h UP,UA and Scr in both groups before and after treatment were recorded by automatic biochemical analyzer.The incidences of fetal distress,neonatal death,placental abruption,postpartum hemorrhage,cesarean section and fetal growth restriction were compared between the two groups.The clinical efficacy of both groups and the impact on pregnancy outcomes were compared.Results The FIB,APTT,PT,BUN,24h UP,UA,Scr,platelet,systolic blood pressure and diastolic blood pressure were compared between the observation group and the control group after treatment.And before and after treatment in the same group,there was statistical significance(P<0.05).The fetal distress,neonatal death,placental abruption,postpartum hemorrhage And the incidence of fetal growth restriction,were lower than the control group(P<0.05).Conclusion The combination of low molecular weight heparin and aspirin in pregnancy patients with early onset severe preeclampsia can help to improve the clotting factor,blood pressure and renal function and improve the pregnancy outcome,which is worth popularizing and applying.