国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
1期
71-74
,共4页
低分子肝素钠%心脏病换瓣术%妊娠早期%应用
低分子肝素鈉%心髒病換瓣術%妊娠早期%應用
저분자간소납%심장병환판술%임신조기%응용
Low molecular weight heparin%Heart valve replacement%First trimester%Use
目的 探讨低分子肝素钠在心脏病换瓣术后妊娠早期的应用.方法 本文选取55例心脏病换瓣术后孕妇,在妊娠早期使用低分子肝素钠进行抗凝治疗(简称治疗组),并随机选取55例心脏病换瓣术后孕妇,在妊娠早期使用华法林作为对照(简称对照组).结果 治疗组55例,发现胎儿畸形2例,发生率3.63％；自然流产4例,发生率7.27％抗凝效果良好45例,占81.81％,1例出现心脏瓣膜功能障碍而重新换瓣并终止妊娠,发生率1.81％,.对照组55例,发现胎儿畸形8例,发生率14.55％;自然流产12例,发生率21.81％;抗凝效果良好53例,占96.36％;未发现心脏瓣膜功能障碍病例.两组在胎儿畸形和自然流产比较,差异有显著性(P＜0.05).结论 心脏病换瓣术后妊娠早期抗凝剂选用低分子肝素钠胎儿致畸率及自然流产相对较低,但抗凝效果及导致孕妇心脏瓣膜功能障碍华法令稍优于低分子肝素钠.故心脏病换瓣术后患者在妊娠早期抗凝剂选择用低分子肝素可以降低胎儿畸形率及自然流产率,对母婴无明显副作用,是一种安全、有效的药物.
目的 探討低分子肝素鈉在心髒病換瓣術後妊娠早期的應用.方法 本文選取55例心髒病換瓣術後孕婦,在妊娠早期使用低分子肝素鈉進行抗凝治療(簡稱治療組),併隨機選取55例心髒病換瓣術後孕婦,在妊娠早期使用華法林作為對照(簡稱對照組).結果 治療組55例,髮現胎兒畸形2例,髮生率3.63％；自然流產4例,髮生率7.27％抗凝效果良好45例,佔81.81％,1例齣現心髒瓣膜功能障礙而重新換瓣併終止妊娠,髮生率1.81％,.對照組55例,髮現胎兒畸形8例,髮生率14.55％;自然流產12例,髮生率21.81％;抗凝效果良好53例,佔96.36％;未髮現心髒瓣膜功能障礙病例.兩組在胎兒畸形和自然流產比較,差異有顯著性(P＜0.05).結論 心髒病換瓣術後妊娠早期抗凝劑選用低分子肝素鈉胎兒緻畸率及自然流產相對較低,但抗凝效果及導緻孕婦心髒瓣膜功能障礙華法令稍優于低分子肝素鈉.故心髒病換瓣術後患者在妊娠早期抗凝劑選擇用低分子肝素可以降低胎兒畸形率及自然流產率,對母嬰無明顯副作用,是一種安全、有效的藥物.
목적 탐토저분자간소납재심장병환판술후임신조기적응용.방법 본문선취55례심장병환판술후잉부,재임신조기사용저분자간소납진행항응치료(간칭치료조),병수궤선취55례심장병환판술후잉부,재임신조기사용화법림작위대조(간칭대조조).결과 치료조55례,발현태인기형2례,발생솔3.63％；자연유산4례,발생솔7.27％항응효과량호45례,점81.81％,1례출현심장판막공능장애이중신환판병종지임신,발생솔1.81％,.대조조55례,발현태인기형8례,발생솔14.55％;자연유산12례,발생솔21.81％;항응효과량호53례,점96.36％;미발현심장판막공능장애병례.량조재태인기형화자연유산비교,차이유현저성(P＜0.05).결론 심장병환판술후임신조기항응제선용저분자간소납태인치기솔급자연유산상대교저,단항응효과급도치잉부심장판막공능장애화법령초우우저분자간소납.고심장병환판술후환자재임신조기항응제선택용저분자간소가이강저태인기형솔급자연유산솔,대모영무명현부작용,시일충안전、유효적약물.
Objective To investigate the use of low molecular weight heparin for women in their first trimester after heart valve replacement.Methods 55 pregnant women in their first trimester after heart valve replacement received anticoagulant therapy with low molecular weight heparin ( study group ),and another 55 pregnant women with the same medical conditions received warfarin ( control group ).Results In the study group,fetal malformation was found in 2 of 55 women( 3.63％ ),spontaneous abortion occurred in 4 ( 7.27％ ),and cardiac valve dysfunction developed in one woman ( 1.81％ ) and she needed repeat valve replacement and termination of pregnancy; the anticoagulant effect was better in 45 women ( 81.81％ ).In the control group,fetal malformation was found in 8 women ( 14.55％ ),spontaneous abortion occurred in 12 ( 21.81％ ); the anticoagulant effect was bettere in 53 women ( 96.36％ ) and heart valve dysfunction was not found.The incidence rates of fetal malformation and spontaneous abortion differed significantly between the two groups ( P ＜ 0.05 ).Conclusions Low molecular weight heparin for women in their first trimester after heart valve replacement has lower incidence rates of spontaneous abortion and fetal malformation,but has a lower anticoagulant effect than warfarin and might induce heart valve dysfunction.It is a safe and effective medication.
