摘要
目的探讨妊娠期高血压疾病应用低分子肝素治疗的有效性及对患者纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)的影响。方法选取2020年3月至2021年3月在驻马店市中心医院治疗的妊娠期高血压疾病患者104例,根据治疗方法的不同分为对照组和研究组,每组52例。对照组应用阿司匹林,研究组在此基础上应用低分子肝素(LMWH),观察两组治疗前后凝血指标变化、血压变化、尿蛋白水平、血浆总蛋白水平变化情况,以及产妇、新生儿的不良妊娠结局发生情况。结果研究组治疗后FIB低于对照组,而PT、TT、APTT均较对照组高(P<0.05)。研究组治疗后舒张压、收缩压均较对照组低(P<0.05)。研究组治疗后尿蛋白水平低于对照组,而血浆总蛋白水平高于对照组(P<0.05)。研究组难产、早产、死胎、子宫切除、产后出血、失血休克发生率均较对照组低(P<0.05)。结论妊娠期高血压疾病患者单独应用阿司匹林无法有效降低发生不良妊娠结局的概率,而联合应用低分子肝素+阿司匹林治疗相较于单独用药效果更佳,其不仅可以有效改善患者的相关凝血指标、血压情况及尿蛋白和血浆总蛋白水平,还可以降低母婴不良妊娠结局的发生率,值得推广和应用。
【Objective】To explore the effectiveness of low-molecular-weight heparin treatment for hypertension in pregnancy and its effect on patients'PT,APTT,TT,FIB.【Methods】A total of 104 patients with hypertension during pregnancy in our hospital from March 2020 to March 2021 were selected and randomly divided into two groups.The control group was treated with aspirin,the study group was treated with low-molecular-weight heparin on this basis,and the changes in blood coagulation indexes,blood pressure,urine protein levels,plasma total protein levels,and adverse pregnancy outcomes of mothers and newborns before and after treatment in the two groups were observed.【Results】After treatment,the FIB of the study group was lower than that of the control group,and PT,TT and APTT were higher than those of the control group(P<0.05);DBP and SBP of the study group after treatment were lower than those of the control group(P<0.05);urine protein level of the study group after treatment was lower than the control group,and the plasma total protein level was higher than that of the control group(P<0.05);the incidence of dystocia,premature delivery,stillbirth,hysterectomy,postpartum hemorrhage,and hemorrhagic shock in the study group was lower than that in the control group(P<0.05).【Conclusion】Aspirin alone cannot effectively reduce the chance of adverse pregnancy outcome in patients with hypertension in pregnancy.The combined low-molecular-weight heparin+aspirin therapy is more effective than single medication,and it can not only effectively improve the patient's blood coagulation indicators,blood pressure,urine protein and plasma total protein levels,but also reduce the incidence of adverse pregnancy outcomes for mothers and infants.It is worthy of promotion and application.
作者
张珊珊
ZHANG Shanshan(Department of Obstetrics,Zhumadian Central Hospital,Zhumadian,Henan 463003,China)
出处
《中国医学工程》
2022年第2期76-79,共4页
China Medical Engineering
关键词
妊娠期高血压疾病
低分子肝素
有效性
治疗结果
hypertension in pregnancy
low molecular weight heparin
effectiveness
treatment results