硫酸镁联合低分子肝素钠对重度子痫前期患者血压控制及母婴结局的影响

摘要

Objective To investigate the effect of magnesium sulfate combined with low molecular weight heparin on blood pressure control and maternal and neonatal outcomes in severe preeclampsia patients.Methods From January 2014 to September 2016,86 patients with severe preeclampsia in our hospital were divided into control group and observation group according to the treatment plan,43 cases in each group.The control group was treated with magnesium sulfate,and the observation group was treated with low molecular weight heparin on the basis.Blood pressure [diastolic blood pressure (DBP),systolic blood pressure (SBP)],coagulation function index [blood viscosity,blood flow resistance index (RI),hematocrit (HCT)] of the two groups before and after treatment were compared,and adverse pregnancy outcomes were statistically analyzed as well.Results There were no statistically significant differences in SBP,DBP,blood viscosity,RI,and HCT levels between the two groups before treatment (P＞0.05);after treatment,the levels of SBP [(138.25±8.43) mmHg],DBP [(92.25±5.17) mmHg],blood viscosity [(1.43±0.27) mPa·s],RI [(0.31±0.06)],and HCT [(39.58±5.33)％] of the observation group were all lower than those of the control group,with statistically significant differences (P＜0.05).The rate of premature delivery in the observation group was 9.30％ (4/43),the rate of postpartum hemorrhage was 4.65％ (2/43),the rate of fetal distress was 6.98％ (3/43),and the rate of neonatal asphyxia was 2.33％ (1/43),which were all lower than those in the control group [25.58％ (11/43),18.60％ (8/43),23.26％ (10/43),18.60％ (8/43)],with statistically significant differences (P＜0.05).Conclusion In the treatment of severe preeclampsia,magnesium sulfate combined with low molecular weight heparin can effectively reduce blood pressure level,improve blood hypercoagulable state,and thus it can help improve maternal and neonatal outcomes.%目的 探讨硫酸镁联合低分子肝素钠对重度子痫前期患者血压控制及母婴结局的影响.方法 选取2014年1月至2016年9月本院86例重度子痫前期患者,根据不同治疗方案分组,各43例.对照组给予硫酸镁治疗,观察组在此基础上联合低分子肝素钠治疗.两组治疗前后血压[舒张压(DBP)、收缩压(SBP)]、凝血功能指标[血液黏度、血流阻力指数(RI)、红细胞比容(HCT)]水平比较,并统计不良妊娠结局发生率.结果 治疗前,两组SBP、DBP水平及血液黏度、RI、HCT差异无统计学意义(P＞0.05),经治疗,观察组SBP(138.25±8.43) mmHg(1 mmHg=0.133 kPa)、DBP(92.25±5.17)mmHg水平及血液黏度(1.43±0.27) mPa·s、RI(0.31±0.06)、HCT(39.58±5.33)％均低于对照组,差异有统计学意义(P＜0.05);观察组早产率9.30％(4/43)、产后出血率4.65％(2/43)、胎儿窘迫率6.98％(3/43)及新生儿窒息率2.33％(1/43)低于对照组25.58％ (11/43)、18.60％ (8/43)、23.26％(10/43)、18.60％(8/43),差异有统计学意义(P＜0.05).结论 给予重度子痫前期硫酸镁联合低分子肝素钠治疗,可有效降低患者血压水平、改善血液高凝状态,进而有利于改善母婴结局.