低分子肝素钠联合黄体酮对先兆流产的疗效分析

Effect of low molecular weight heparin sodium combined with progesterone in the treatment of threatened abortion

目的观察并分析低分子肝素钠联合黄体酮治疗先兆流产的临床疗效。方法回顾性选取2017年1月至2018年6月在杭州市余杭区第一人民医院妇产科就诊的先兆流产患者241例作为研究对象,其中将采用低分子肝素钠联合黄体酮进行治疗的125例患者作为观察组,采用常规剂量黄体酮治疗的116例患者作为对照组。收集并比较两组患者的临床疗效以及腰酸、阴道流血、腹痛以及总治疗时间;同时比较两组患者治疗前后超敏C-反应蛋白、纤维蛋白原、D-二聚体、血小板水平的变化以及药物不良反应发生情况。结果经比较,观察组的总有效率显著高于对照组(92.00%vs. 80.17%,χ^2=7.122,P=0.008),且观察组腰酸、阴道出血、腹痛等症状持续时间以及总治疗时间也都显著低于对照组患者(t值分别为19.369、4.474、 5.145、14.502,均P<0.001)。此外,观察组超敏C-反应蛋白、纤维蛋白原、D-二聚体、血小板等指标的下降程度也显著高于对照组(t值分别为12.621、10.828、4.653、2.099,均P<0.05),且观察组不良反应的发生率显著低于对照组(5.60%vs.16.38%,χ^2=7.264,P=0.007)。结论相比单纯使用黄体酮,联用低分子肝素钠治疗先兆流产时,可以提高临床治疗效果,降低不良反应发生率,具有较高的有效性及用药安全性。

Objective To observe the clinical efficacy of low molecular weight heparin and progesterone in patients with threatened abortion. Methods 241 patients with threatened abortion admitted in the First People’s Hospital of Yuhang between January 2017 and June 2018 were enrolled: 125 patients treated with low molecular weight heparin combined with progesterone was used as the observation group, and 116 patients treated with conventional doses of progesterone were used as the control group. The clinical efficacy, backache, vaginal bleeding, abdominal pain time, total treatment time of the two groups were recorded and compared. And the high-sensitivity C-reactive protein, fibrinogen, D-dimer, platelet level and drug adverse effects were also collected and compared before and after treatment. Results By comparison, the total effective rate in the observation group was significantly higher than control group(92.00% vs. 80.17%,χ^2=7.122, P=0.008), and the duration of lumbar acid, vaginal bleeding, abdominal pain and the total treatment time in the observation group were also significantly lower than those in the control group(t value was 19.369, 4.474, 5.145 and 14.50, respectively, all P<0.001). Meanwhile, the changes of hypersensitive C-reactive protein, fibrinogen, D-dimeric and platelet in the observation group before and after treatment were all significantly higher than those in the control group(t value was 12.621, 10.828, 4.653 and 2.099, respectively, all P<0.05), and the risk of adverse reactions in the observation group was significantly lower than that in the control group(5.60% vs. 16.38%,χ^2=7.264, P=0.007). Conclusion Low molecular weight heparin combined with progesterone has higher efficacy and safety, which can improve the clinical efficacy and reduce the risk of adverse reactions in the treatment of threatened abortion.