中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
3期
1-3
,共3页
早发型重度子痫前期%低分子肝素%病理性高凝状态
早髮型重度子癇前期%低分子肝素%病理性高凝狀態
조발형중도자간전기%저분자간소%병이성고응상태
Early onset severe preeclampsia%Low molecular weight heparin%Pathological hypercoagulable state
目的：应用低分子肝素治疗早发型重度子痫前期,探索其治疗的有效性。方法选取2012年8月~2013年8月在河南省人民医院产科住院的早发型重度子痫前期患者60例,随机分为治疗组与对照组各30例。对照组给予硫酸镁针、心痛定片常规解痉、降压治疗,观察组在此基础上加用低分子肝素钙针(商品名：速碧林),脐周皮下注射,4100 U/d,连续7 d,隔周重复疗程。比较应用低分子肝素治疗前后的凝血酶原时间(prothrombin time, PT)、凝血酶时间(thrombin time, TT)、D-二聚体,用彩超多普勒测量胎儿的脐动脉、大脑中动脉的S/D值,并记录分娩结局。结果治疗组治疗前后脐动脉S/D、大脑中动脉S/D、TT、D-二聚体的指标变化差异有统计学意义(P<0.05)。治疗后两组脐动脉S/D、大脑中动脉S/D、D-二聚体的指标变化差异有统计学意义(P<0.05)。两组的Apgar评分、出生体重、胎儿死亡率差异有统计学意义(P<0.05)。产后出血量两组差异无统计学意义。结论应用低分子肝素钙可明显改善母体的病理性高凝状态,改善新生儿预后,不增加产后出血量,应用于治疗早发型重度子痫前期是安全有效的。
目的：應用低分子肝素治療早髮型重度子癇前期,探索其治療的有效性。方法選取2012年8月~2013年8月在河南省人民醫院產科住院的早髮型重度子癇前期患者60例,隨機分為治療組與對照組各30例。對照組給予硫痠鎂針、心痛定片常規解痙、降壓治療,觀察組在此基礎上加用低分子肝素鈣針(商品名：速碧林),臍週皮下註射,4100 U/d,連續7 d,隔週重複療程。比較應用低分子肝素治療前後的凝血酶原時間(prothrombin time, PT)、凝血酶時間(thrombin time, TT)、D-二聚體,用綵超多普勒測量胎兒的臍動脈、大腦中動脈的S/D值,併記錄分娩結跼。結果治療組治療前後臍動脈S/D、大腦中動脈S/D、TT、D-二聚體的指標變化差異有統計學意義(P<0.05)。治療後兩組臍動脈S/D、大腦中動脈S/D、D-二聚體的指標變化差異有統計學意義(P<0.05)。兩組的Apgar評分、齣生體重、胎兒死亡率差異有統計學意義(P<0.05)。產後齣血量兩組差異無統計學意義。結論應用低分子肝素鈣可明顯改善母體的病理性高凝狀態,改善新生兒預後,不增加產後齣血量,應用于治療早髮型重度子癇前期是安全有效的。
목적：응용저분자간소치료조발형중도자간전기,탐색기치료적유효성。방법선취2012년8월~2013년8월재하남성인민의원산과주원적조발형중도자간전기환자60례,수궤분위치료조여대조조각30례。대조조급여류산미침、심통정편상규해경、강압치료,관찰조재차기출상가용저분자간소개침(상품명：속벽림),제주피하주사,4100 U/d,련속7 d,격주중복료정。비교응용저분자간소치료전후적응혈매원시간(prothrombin time, PT)、응혈매시간(thrombin time, TT)、D-이취체,용채초다보륵측량태인적제동맥、대뇌중동맥적S/D치,병기록분면결국。결과치료조치료전후제동맥S/D、대뇌중동맥S/D、TT、D-이취체적지표변화차이유통계학의의(P<0.05)。치료후량조제동맥S/D、대뇌중동맥S/D、D-이취체적지표변화차이유통계학의의(P<0.05)。량조적Apgar평분、출생체중、태인사망솔차이유통계학의의(P<0.05)。산후출혈량량조차이무통계학의의。결론응용저분자간소개가명현개선모체적병이성고응상태,개선신생인예후,불증가산후출혈량,응용우치료조발형중도자간전기시안전유효적。
Objective To investigate the effect of low molecular weight heparin (LMWH) on early-onset severe preeclampsia and analyze their pregnancy outcomes. Methods A total of 60 patients with early onset preeclampsia were selected in Henan Province People’s Hospital. The patients were randomly divided into observation group (n=30) and control group (n=30). The cases of the control group were treated with magnesium sulfate and nifedipine. The cases of the observation group were treated with magnesium sulfate, nifedipine and LMWH (FraxiParine). Prothrombin Time(PT), Thrombin Time (TT), D-Dimer, S/D value of fetal umbilical and middle cerebral arteries and pregnancy outcome were observed. Results S/D value of fetal umbilical and middle cerebral arteries, TT, DD after treatment in the observation group are different with that of before treatment. The differences of S/D value of fetal umbilical and middle cerebral arteries, DD, Apgar scores, birth weight, fetal mortality between the two groups was statistically significant (P<0.05). The incidence of postpartum hemorrhage between two groups was shown no significant difference(P>0.05). Conclusion The application of low molecular heparin in early onset severe preeclampsia can improve the hypercoagulabale state and maternal and fetal outcomes. The incidence of postpartum hemorrhage is not increased.
