甲氧氯普胺配合静脉补液对于妊娠剧吐的影响

Effect of metoclopramide combined with intravenous rehydration on hyperemesis gravidarum

目的:探讨甲氧氯普胺配合静脉补液对于妊娠剧吐的影响。方法:选择2017年9月—2020年9月在江西省百佳艾玛妇产医院行孕期产检的妊娠剧吐患者50例。按照随机数字表法分为两组,每组25例。对照组采取单纯静脉补液。观察组在对照组基础上静脉注射甲氧氯普胺,10 mg/次,1次/d,治疗5 d。观察两组疗效、妊娠恶心呕吐生活质量量表(NVPQOL)评分、尿酮体转阴时间、3 d内呕吐频次、不良反应、C反应蛋白(CRP)水平、白细胞介素-6(IL-6)水平、中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞比值(PLR)。结果:观察组总有效率为92.00%,高于对照组的64.00%(P<0.05)。观察组干预后NVPQOL评分中的躯体症状及恶化因素、疲乏、情绪、受限评分均低于干预前及对照组(均P<0.05)。观察组尿酮体转阴时间为(3.27±0.44)d,早于对照组的(4.58±0.69)d(P<0.05);3 d内呕吐频次为(2.51±0.46)次,少于对照组的(4.79±0.76)次(P<0.05)。观察组干预后CRP、IL-6水平均低于干预前及对照组(P<0.05)。观察组和对照组不良反应均较少,组间比较差异无统计学意义(P>0.05)。结论:甲氧氯普胺配合静脉补液对于妊娠剧吐有积极的影响,能够降低NVPQOL评分,缩短尿酮体转阴时间,减少呕吐频次,改善机体的CRP、IL-6水平,有较好的临床疗效,且并不增加患者的不良反应。

Objective:To explore the effect of metoclopramide combined with intravenous rehydration on hyperemesis gravidarum.Methods:From September 2017 to September 2020,50 patients with hyperemesis gravidarum who underwent prenatal examination in Jiangxi Baijia Emma Obstetrics and Gynecology Hospital were selected and according to the random number table method,divided into two groups with 25 cases in each group.The control group was given intravenous rehydration only.On the basis of the control group,the observation group was given metoclopramide intravenously,10 mg/time,once a day,for 5 days.Curative effect,quality of life instrument for nausea and vomiting of pregnancy(NVPQOL)score,urinary ketone body negative time,frequency of vomiting within 3 days,adverse reactions,C-reactive protein(CRP)level,interleukin-6(IL-6)level,neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)were observed.Results:The total effective rate was 92.00%in the observation group,which was higher than 64.00%in the control group(P<0.05).The scores of physical symptoms and worsening factors,fatigue,mood,and restriction in the NVPQOL scores in the observation group after the intervention were lower than those before the intervention and in the control group(all P<0.05).The time of urine ketone body turning negative in the observation group was(3.27±0.44)d,which was earlier than(4.58±0.69)d in the control group(P<0.05);the frequency of vomiting within 3 days was(2.51±0.46),which was less than(4.79±0.76)times in the control group(P<0.05).After the intervention,the levels of CRP and IL-6 in the observation group were significantly lower than those before the intervention and in the control group(P<0.05),the observation group and the control group had fewer adverse reactions,and the difference between the groups was not statistically significant(P>0.05).Conclusion:Metoclopramide combined with intravenous rehydration has a positive effect on hyperemesis gravidarum,can reduce the NVPQOL score,shorten the time for urinary ketone bodies to become negative,reduce the frequency of vomiting,and improve the body’s CRP and IL-6 levels,which has a good clinical effect,and does not increase the patient’s adverse reactions.