米索前列醇联合硫酸镁对妊娠高血压综合征产后出血量及血压的影响观察

Observation of the effect of misoprostol combined with magnesium sulfate on postpartum hemorrhage and blood pressure of patients with pregnancy-induced hypertension syndrome

目的研究妊娠高血压综合征产妇采取米索前列醇联合硫酸镁治疗对血压及产后出血量的影响。方法选取66例妊娠高血压综合征产妇,经区组随机化分组法分为对照组和观察组,每组33例。对照组产妇采取硫酸镁治疗,观察组产妇采取米索前列醇联合硫酸镁治疗。比较两组产妇产后出血量、血压、凝血功能、应激反应以及不良妊娠结局发生率。结果观察组产后2、24 h出血量分别为(198.31±15.20)、(296.09±16.12)ml,均少于对照组的(289.09±17.73)、(403.07±18.02)ml(P<0.05)。与治疗前比较,两组治疗后舒张压、收缩压、平均动脉压均下降,差异有统计学意义(P<0.05);但治疗后两组舒张压、收缩压、平均动脉压比较,差异无统计学意义(P>0.05)。与治疗前比较,两组治疗后纤维蛋白原均下降,凝血酶原时间、活化部分凝血活酶时间均延长,且观察组治疗后纤维蛋白原(3.96±0.72)g/L高于对照组的(3.26±0.88)g/L,凝血酶原时间(10.93±1.26)s、活化部分凝血活酶时间(31.28±2.09)s均短于对照组的(12.35±1.81)、(35.18±2.87)s(P<0.05)。与治疗前比较,两组治疗后丙二醛(MDA)均下降,超氧化物歧化酶(SOD)均上升,且观察组治疗后MDA(12.90±1.59)nmol/ml低于对照组的(17.86±2.15)nmol/ml,SOD(123.78±12.96)U/ml高于对照组的(90.45±9.68)U/ml(P<0.05)。观察组不良妊娠结局发生率9.09%比对照组的30.30%更低(P<0.05)。结论米索前列醇与硫酸镁联治能够有效改善妊娠高血压综合征产妇的血压水平,减少产后出血量及不良妊娠结局发生率,具有推广应用意义。

Objective To study the effect of misoprostol combined with magnesium sulfate on postpartum hemorrhage and blood pressure of patients with pregnancy-induced hypertension syndrome.Methods A total of 66 women with pregnancy-induced hypertension syndrome were randomly divided into a control group and an observation group,with 33 cases in each group.The control group was treated with magnesium sulfate,while the observation group was treated with misoprostol combined with magnesium sulfate.The postpartum hemorrhage,blood pressure,coagulation function,stress response,and incidence of adverse pregnancy outcomes were compared between the two groups.Results The bleeding volume of the observation group were(198.31±15.20)and(296.09±16.12)ml at 2 and 24 h postpartum,which were lower than the control group's(289.09±17.73)and(403.07±18.02)ml(P<0.05).Compared with before treatment,the diastolic blood pressure,systolic blood pressure and mean arterial pressure of the two groups decreased after treatment,and the difference was statistically significant(P<0.05).But there was no significant difference in diastolic blood pressure,systolic blood pressure and mean arterial pressure between the two groups after treatment(P>0.05).Compared with before treatment,the fibrinogen decreased in both groups after treatment,and thrombin time and activated partial thromboplastin time prolonged in both groups;after treatment,the observation group had higher fibrinogen of(3.96±0.72)g/L than(3.26±0.88)g/L in the control group;the observation group had prothrombin time of(10.93±1.26)s and activated partial thromboplastin time of(31.28±2.09)s,which were shorter than(12.35±1.81)and(35.18±2.87)s in the control group(P<0.05).Compared with before treatment,both groups showed a decrease in malondialdehyde(MDA)and an increase in superoxide dismutase(SOD)after treatment;the observation group had lower MDA of(12.90±1.59)nmol/ml after treatment than(17.86±2.15)nmol/ml in the control group,and higher SOD of(123.78±12.96)U/ml than(90.45±9.68)U/ml in the control group(P<0.05).The incidence of adverse pregnancy outcome of 9.09%in the observation group was lower than 30.30%in the control group(P<0.05).Conclusion The combination of misoprostol and magnesium sulfate can effectively reduce blood pressure levels,postpartum hemorrhage,and the incidence of adverse pregnancy outcome in patients with pregnancy-induced hypertension syndrome,and has practical significance for promotion.