半夏白术天麻汤联合小剂量低分子肝素钙对早发型重度子痫前期患者凝血功能及母婴结局的影响

Effects of Banxia Baizhu Tianma Decoction Combined with Low-dose Low-molecular-weight Heparin Calcium on Coagulation Function and Maternal and Infant Outcomes in Patients with Early Onset Severe Preeclampsia

【目的】探讨半夏白术天麻汤联合小剂量低分子肝素钙对早发型重度子痫前期(EOSP)患者凝血功能及母婴结局的影响。【方法】按患者自愿原则将106例EOSP患者分为肝素组51例和试验组55例。2组患者均给予常规综合治疗(包括解痉、降压、促进胎肺成熟和支持治疗等),在此基础上,对照组给予小剂量低分子肝素钙治疗,试验组给予半夏白术天麻汤联合小剂量低分子肝素钙治疗,疗程为1周,并随访至分娩后3个月。观察2组患者治疗前后凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)等凝血功能指标的变化情况,并比较2组患者的终止妊娠时间、产后2 h出血量、分娩方式、并发症发生率及围生儿结局等母婴结局情况。【结果】(1)治疗后,2组患者的PT、APTT、TT均较治疗前延长(P<0.05),但组间比较,试验组的PT、APTT、TT均明显短于对照组,差异均有统计学意义(P<0.01)。(2)经随访,试验组患者的终止妊娠时间长于对照组,差异有统计学意义(P<0.01),而2组患者的产后2 h出血量、分娩方式以及围生儿结局和并发症发生率比较,差异均无统计学意义(P>0.05)。【结论】半夏白术天麻汤联合小剂量低分子肝素钙治疗,可调节EOSP患者凝血功能,改善母婴结局。

Objective To investigate the effect of Banxia Baizhu Tianma Decoction combined with low-dose lowmolecular-weight heparin calcium on coagulation function and maternal and infant outcomes in patients with early onset severe preeclampsia(EOSP).Methods A total of 106 EOSP patients were divided into control group(51 cases)and trial group(55 cases)following the voluntary principle.Both groups of the patients were given conventional comprehensive treatment for spasmolysis,lowering blood pressure,promoting fetal lung maturity and supportive treatment,etc.And additionally,the control group was given low-dose low-molecular-weight heparin calcium,while the treatment group was given oral use of Banxia Baizhu Tianma Decoction combined with low-dose lowmolecular-weight heparin calcium.The course of treatment lasted for one week,and the follow-up continued till3 months after delivery.The changes of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and other coagulation function indexes in the two groups were observed before and after treatment.Meanwhile,the maternal and infant outcomes of time for terminating pregnancy,2-hour postpartum blood loss,mode of delivery,incidence of complications,and perinatal outcomes between the two groups were compared.Results(1)After treatment,PT,APTT and TT in the two groups were prolonged compared with those before treatment(P<0.05).However,the intergroup comparison showed that the PT,APTT and TT in the trial group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).(2)The follow-up result showed that the time for terminating pregnancy in the trial group was longer than that in the control group,and the difference was statistically significant(P<0.01).However,there were no statistically significant differences in 2-hour postpartum blood loss,mode of delivery,perinatal outcomes and the incidence of complications between the two groups(P>0.05).Conclusion Banxia Baizhu Tianma Decoction combined with low-dose low-molecular-weight heparin calcium is effective in regulating coagulation function of EOSP patients and improving maternal and infant outcomes.