妊娠期高血压疾病患者围生期凝血指标及血小板参数的变化研究

Study on Changes of Blood Coagulation Index and Platelet Parameters during Perinatal Period in Patients with Hypertensive Disorder Complicating Pregnancy

目的:探讨妊娠期高血压疾病患者在围生期的凝血指标和血小板参数变化情况。方法:纳入笔者所在医院2014年2月-2018年12月确诊为妊娠期高血压疾病的产妇150例为观察组,另选取同时期90例健康分娩产妇为对照组,检测并比较两组产妇产前、第一产程、第二产程和产后5 min四个时间点的凝血指标凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(Fib)和血小板参数血小板计数(PLT)、血小板平均体积(MPV)、血小板分部宽度(PDW)。结果:观察组PT、APTT、TT值均低于对照组,Fib值高于对照组,差异均有统计学意义(P<0.05);两组第二产程PT、APTT、TT均低于其他时间段,Fib值均高于其他时间段,差异均有统计学意义(P<0.05)。观察组PLT低于对照组,MPV和PDW均高于对照组,差异均有统计学意义(P<0.05);两组第二产程PLT均低于其他时间段,MPV和PDW均高于其他时间段,差异均有统计学意义(P<0.05)。结论:妊娠期高血压疾病产妇围生期凝血指标与血小板参数具有明显变化,应根据不同时段的变化加强干预,预防严重并发症的发生。

Objective: To investigate the changes of blood coagulation indexs and platelet parameters in perinatal period in hypertensive patients in pregnancy. Method: A total of 150 parturients with hypertensive disorder complicating pregnancy diagnosed in my hospital from February 2014 to December 2018 were observed as the observation group, in addition, 90 healthy parturients in the same period were selected as the control group. The coagulation index prothrombin time(PT), partial thrombin time(APTT), thrombin time(TT) and fibrinogen(Fib) and Platelet parameters Platelet count(PLT), platelet average volume(MPV), platelet branch width(PDW) were measured and compared between the two groups before delivery, first labor, second labor and postpartum 5 min. Result: The values of PT, APTT and TT in the observation group were lower than that of the control group, and the value of Fib was higher than that of the control group, the differences were statistically significant(P<0.05). The second stage of labor PT, APTT and TT of the two groups were lower than the other time periods, and the Fib values were higher than that of other time periods, the differences were statistically significant(P<0.05). In the observation group, PLT was lower than that of the control group, and both MPV and PDW were higher than that in the control group, the differences were statistically significant(P<0.05). The PLT of the second stage of labor in the two groups was lower than that in other time periods, MPV and PDW were higher than those in other time periods, the differences were statistically significant(P<0.05). Conclusion: The perinatal coagulation index and platelet parameters of pregnant women with hypertension have obvious changes. The intervention should be strengthened according to the changes of different time periods to prevent the occurrence of serious complications.