前瞻性研究法和经验治疗改善妊娠贫血和分娩结果的效果比较

摘要

比较前瞻性研究法与经验治疗对妊娠贫血及分娩结果的疗效，以改善妊娠贫血状况及母儿结局。方法：随机选取2010年11月至2013年11月本院产科妊娠贫血患者300例，根据不同的治疗方法，分为研究组（前瞻性研究法治疗组）与对照组（经验治疗组）各150例。治疗4周后，对比观察两组患者的叶酸、VitB12与血清铁蛋白含量，治疗前后贫血改善情况及妊娠结局（妊娠期高血压、早产、产后出血、低体重儿及胎儿窘迫发生情况）。结果：治疗前，两组患者的外周血血红蛋白含量、贫血程度比例、叶酸、VitB12及血清铁蛋白含量差异无统计学意义（ P＞0．05）。治疗四周后，研究组患者根据不同病因分类后的相关指标值（外周血血红蛋白、叶酸、VitB12及血清铁蛋白含量）均较对照组高，差异有统计学意义（P＜0．05）；研究组患者贫血治愈率为136例（90．67％），高于对照组患者的54例（36．00％），差异有统计学意义（P＜0．05）；研究组妊娠结局不健康合计值22例（14．67％），明显低于对照组的70例（46．67％），差异有统计学意义（P＜0．05）。结论：妊娠期贫血主要是缺铁性贫血。采用前瞻性研究法，予以妊娠期贫血患者针对性的病因治疗，符合科学循证医学原则，能有效提升贫血患者外周血血红蛋白、叶酸、VitB12及血清铁蛋白含量，提高贫血治愈率，降低母婴并发症发生，改善结局。%To compare efficacy prospective study and experience treatment of anemia in pregnancy and childbirth , to improve pregnancy anemia and pregnancy outcomes .Method: There hundred patients with anemia of pregnancy ( November 2010 to November 2013 ) , were divided into study group ( prospective study treatment group ) and control group ( treatment group ) , each group with 150 cases accord-ing to the different treatment methods .After 4 weeks of treatment , folic acid, VitB12 and serum ferritin levels were observed , the improve situation of anemia after the treatment and pregnancy outcomes ( gestational hy-pertension , preterm delivery , postpartum hemorrhage , low birth weight children and the incidence of fetal distress ) were analyzed .Result:Before treatment , the different of patient's peripheral blood hemoglobin , the proportion of the degree of anemia , folic acid , VitB12 and serum ferritin levels were no statistically sig-nificant difference (P>0.05).After four weeks of treatment, the levels ( peripheral blood hemoglobin, folic acid , VitB12 and serum ferritin ) of study group were higher than those in control group , the difference was statistically significant (P <0.05).The cure rate of study group was 136 cases ( 90.67%) , which was higher than that in control group (54 cases, 36.00%), the difference was statistically significant (P <0. 05).The numbers of unhealthy pregnancy of study group were total 22 cases ( 14.67%), less than that in the control group (70 cases, 46.67%) , the difference was statistically significant (P <0.05).Conclusion:Iron deficiency anemia mainly occurs in gestational period .A prospective study , targeted to be the cause of a-nemia in pregnancy treatment , in line with the principles of science and evidence-based medicine , which can effectively improve the levels of hemoglobin , folic acid , VitB12 and serum ferritin, improve cure rate of anemia, reduce maternal and child complications and improve outcomes of pregnancy .