临产前高压氧治疗对妊娠期高血压疾病患者分娩结局的影响

Effect of pre-parturition hyperbaric oxygen therapy on the delivery outcome of patients with hypertensive disorder complicating pregnancy

目的观察妊娠期高血压疾病(HDCP)患者临产前经高压氧(HBO)治疗的效果,指导优化未来HDCP治疗方案。方法选取2015年1月至2020年1月在南京医科大学附属常州市第二人民医院分娩的200例HDCP患者,采用数字奇偶法分为观察组和对照组,每组100例。对照组接受常规治疗联合硫酸镁治疗,观察组在对照组的基础上于临产前联合HBO治疗,分别于治疗前、分娩后测量2组患者血压、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)及纤维蛋白原(FIB),记录2组患者分娩结局、胎儿结局和观察组HBO治疗期间不良反应发生情况。结果分娩后,2组患者收缩压、舒张压均较治疗前降低,且观察组患者收缩压、舒张压均低于对照组,差异有统计学意义(P<0.05或P<0.01);2组患者PT、APTT值较治疗前升高,FIB值较治疗前降低,且观察组患者PT、APTT值高于对照组,FIB值低于对照组,差异均有统计学意义(P<0.05);观察组顺产率高于对照组,产后出血、产后感染、产后并发症发生率均低于对照组,差异均有统计学意义(P<0.01);2组胎儿结局对比,差异无统计学意义(P>0.05);HBO治疗期间,观察组患者无不良反应发生。结论HDCP患者临产前经HBO治疗,有利于改善患者血压和凝血功能,妊娠结局良好。

Objective To observe the effect of pre-parturition hyperbaric oxygen(HBO)therapy on patients with hypertensive disorder complicating pregnancy(HDCP)for optimizing the treatment plan for HDCP.Methods A total of 200 HDCP patients giving birth a child in Changzhou No.2 People’s Hospital Affiliated to Nanjing Medical University from January 2015 to January 2020 were selected and numbered.They were equally divided into observation group and control group based on odd and even numbers,with 100 cases in each group.The control group received conventional treatment combined with magnesium sulfate,while the observation group was given HBO treatment before labor on the basis of the treatment in the control group.The blood pressure,prothrombin time(PT),activated part thromboplastin time(APTT),and fibrinogen(FIB)of the patients in both groups were measured before treatment and after labor.The delivery outcome and fetal outcome of patients in both groups,and the occurrence of adverse reactions during HBO treatment in the observation group were recorded.Results After labor,the systolic and diastolic blood pressures of patients in both groups were decreased in comparison with those before treatment,and the pressures in the observation group were lower than those in the control group,with statistically significant differences(P<0.05 or P<0.01).Compared with the values before treatment,the PT and APTT values of patients in both groups were increased and the FIB value was decreased;the PT and APTT values in the observation group were higher than those in the control group,while the FIB value in the observation group was lower than that in the control group,and the differences were statistically significant(P<0.05).The observation group had a higher rate of natural birth and lower incidences of postpartum hemorrhage,infection,and complications than the control group,and the differences were statistically significant(P<0.01).There was no statistically significant difference between the fetal outcomes in the two groups(P>0.05).During the HBO treatment,there was no adverse reactions in the observation group.Conclusion HBO treatment for HDCP patients before labor is conducive to control their blood pressure and improve coagulation function,thus leading to good delivery outcomes.