复方硫酸亚铁叶酸片对贫血孕妇的临床效果及对妊娠结局的影响研究

Study on the Clinical Effect of Compound Ferrous Sulfate Folate Tablets on Anemia Pregnant Women and Its Effect on Pregnancy Outcome

目的探讨复方硫酸亚铁叶酸片治疗孕妇贫血的效果及对妊娠结局的影响。方法选取我院(2017年6月至2020年1月)收治的90例贫血孕妇,根据不同治疗分为2组,对照组(n=45)接受一般铁剂治疗,观察组(n=45)接受复方硫酸亚铁叶酸片治疗,对比两组患者临床疗效和贫血指标[血红蛋白(Hb)、血清铁蛋白(SF)、红细胞计数(RBC)]、不良反应(便秘、上腹痛、恶心呕吐等)、不良妊娠结局(神经管畸形、新生儿窒息、低体质量儿、产后出血、娠期高血压(HDCP)、早产)以及新生儿体格生长(出生体质量、头围、身长)情况。结果观察组总有效率93.33%(42/45),对照组总有效率71.11%(32/45),两组孕妇临床疗效对比差异明显(χ~2=16.8869,P<0.05)。治疗后观察组Hb、SF、RBC水平分别为(126.98±13.56)g/L、(55.40±19.25)μg/L、(3.85±1.12)×1012/L,对照组分别为(88.85±11.32)g/L、(39.35±12.62)μg/L、(2.76±0.68)×1012/L,治疗后两组孕妇Hb、SF、RBC水平对比差异明显(t=14.4805、4.6775、5.5805,P<0.05)。观察组总发生率4.44%(2/45),对照组总发生率8.89%(4/45),两组孕妇不良反应对比差异明显(χ~2=1.5916,P<0.05)。观察组神经管畸形、新生儿窒息、低体质量儿、产后出血、HDCP、早产发生率分别为0(0.00)、1例(2.22%)、1例(2.22%)、2例(4.44%)、7例(15.56%)、0(0.00),对照组分别为2例(4.44%)、5例(11.11%)、5例(11.11%)、6例(13.33%)、15例(33.33%)、3例(6.67%),两组神经管畸形、新生儿窒息、低体质量儿、产后出血、HDCP、早产发生率对比差异明显(χ~2=4.5408、6.3523、6.3523、4.8812、8.5485、6.9001,P<0.05)。观察组出生体质量(3347.94±441.01)g、头围(34.32±0.83)cm、身长(51.05±1.65)cm,对照组出生体质量(3183.62±427.35)g、头围(33.49±0.46)cm、身长(49.24±1.66)cm,两组新生儿体格生长情况对比差异明显(t=1.7950、5.8674、5.1876,P<0.05)。结论复方硫酸亚铁叶酸片不仅能有效治疗贫血,改善妊娠结局,还具有极高安全性,值得临床推广。

Objective To explore the effect of compound ferrous sulfate folate tablets on anemia of pregnant women and its effect on pregnancy outcome.Methods 90 pregnant women with anemia admitted to our hospital(from June 2017 to January 2020)were divided into two groups according to different treatments.The control group(n=45)received general iron treatment,and the observation group(n=45)received compound ferrous sulfate tablets.The clinical efficacy and poor blood index[hemoglobin(HB),serum ferritin(SF),red blood cell count(RBC)],adverse reactions were compared between the two groups Should(constipation,epigastric pain,nausea and vomiting,etc.),adverse pregnancy outcome(neural tube malformation,neonatal asphyxia,low birth weight,postpartum hemorrhage,high blood pressure during pregnancy(HDCP),preterm birth),and physical growth of newborn(birth weight,head circumference,body length).Results the total effective rate was 93.33%(42/45)in the observation group and 71.11%(32/45)in the control group.There was a significant difference between the two groups(χ~2=16.8869,P<0.05).After treatment,the levels of Hb,SF and RBC were(126.98±13.56)g/L,(55.40±19.25)μg/L,(3.85±1.12)×1012/L in the observation group and(88.85±11.32)g/L,(39.35±12.62)μg/L,(2.76±0.68)×1012/L in the control group.After treatment,the levels of Hb,SF and RBC in the two groups were significantly different(t=14.4805,4.6775,5.5805,P<0.05).The total incidence of the observation group was 4.44%(2/45),and that of the control group was 8.89%(4/45).The incidence of neural tube malformation,neonatal asphyxia,low birth weight,postpartum hemorrhage,HDCP and preterm delivery in the observation group were 0(0.00),1 case(2.22%),1 case(2.22%),2 cases(4.44%),7 cases(15.56%),0(0.00),respectively,and those in the control group were 2 cases(4.44%),5 cases(11.11%),5 cases(11.11%),6 cases(13.33%),15 cases(33.33%),3 cases(6.67%),respectively There were significant differences in the incidence of infant,postpartum hemorrhage,HDCP and preterm delivery(χ~2=4.5408,6.3523,6.3523,4.8812,8.5485,6.9001,P<0.05).In the observation group,the birth weight was(3347.94±441.01)g,head circumference was(34.32±0.83)cm,body length was(51.05±1.65)cm,in the control group,the birth weight was(3183.62±427.35)g,head circumference was(33.49±0.46)cm,body length was(49.24±1.66)cm,and the comparison of physical growth between the two groups was significantly different(t=1.7950,5.8674,5.1876,P<0.05).Conclusion The compound ferrous sulfate folate tablet is not only effective in treating anemia and improving pregnancy outcome,but also highly safe and worthy of clinical application.