摘要
目的探讨低分子肝素对早发型子痫前期凝血功能及妊娠结局的影响,探索早发型子痫前期的期待治疗方法。方法选取2009年1月－2012年3月我院住院的早发型子痫前期孕妇共80例,按入院孕周分为Ⅰ组（28－31＋6周）、Ⅱ组（32－33＋6周）,两大组又分别按照随机数表单盲分为Ⅰ组A（联合治疗组即研究组）22例,在常规治疗基础上加用低分子肝素治疗,Ⅰ组B（常规治疗组即对照组）19例。Ⅱ组又分Ⅱ组A（联合治疗组即研究组）20例,Ⅱ组B（常规治疗组即对照组）19例,观察四组血压、凝血功能、孕妇并发症、期待治疗时间及围生儿结局。结果四组患者纳入研究时,Ⅰ组A与Ⅰ组B,Ⅱ组A与Ⅱ组B临床指标无差异（P〉0.05）。经治疗,加用低分子肝素组即研究组纤维蛋白原（Fbg）及D二聚体（D-D）显著降低（P〈0.05）;四组孕妇孕周均有显著延长[（32.4±3.3）、（31.3±1.7）、（33.6±0.9）、（33.5±1.2）周],Ⅰ组A孕周延长明显长于Ⅰ组B（P〈0.05）;四组宫内死胎、围生儿死亡发生率差异无统计学意义（P〉0.05）,Ⅰ组A新生儿窒息率较Ⅰ组B低,差异有统计学意义（P〈0.05）;四组孕妇并发症发生率差异无统计学意义（P〉0.05）。结论低分子肝素有助于提高早发型子痫前期孕妇期待治疗效果,可以明显改善围生儿结局,提高母儿安全性。
Objective To investigate the effect of the low-molecular-weight heparin on the coagulation function and preg nancy outcome of early preeclampsia,and to explore the manegement methods to prolong the gestation weeks of early preeclampsia.Methods From January 2009 to march 2012,80 early preeclampsia patients in our hospital were chosen in this study.The patients were divided into two groups named Ⅰ and Ⅱ respectively based on the gestation weeks when they were admitted.Group Ⅰ was in the weeks of 28-31＋6,while group Ⅱ was in the weeks of 32-33＋6.The two groups were divided into two subgroups named A and B by treatment.Group Ⅰ（Ⅱ） A was the study group which was treated by low-molecular-weight heparin plus the routine therapy,while Ⅰ（Ⅱ） B was only by routine therapy that served as controlls.The blood pressure,coagulation function,complications of the prenant women,prolonged days and the outcome of perinate of all the patients were recorded.Results The genaral clinical data in groupⅠ（Ⅱ） A and B was without any signifcant difference（P〉0.05）.The finbrinogen and D-dimer in Ⅰ（Ⅱ） A is lower than that in Ⅰ（Ⅱ） B（P〈0.05）.The days prolonged in groupⅠA,ⅠB,ⅡA and ⅡB [respectively（32.4 ±3.3）,（31.3±1.7）,（33.6±0.9）,（33.5±1.2） weeks] were prolonged,and the days prolonged in groupⅠA was longer than that in ⅠB（P〈0.05）.The fetal death,perinatal death and complications of the prenant women in the four groups had no signifcant difference（P〉0.05）.The prevalence of neonatal asphyxia in groupⅠA was lower than that in ⅠB（P〈0.05）.Conclusion The low-molecular-weiht heparin can elevate the therapeutic value in treatment of prolonging the gestation weeks of early preeclampsia.It can improve the perinatal out come in these patients.And it is safy to the mather and fatal.
出处
《中国医药导报》
CAS
2012年第32期15-17,共3页
China Medical Herald
关键词
早发型子痫前期
低分子肝素
期待治疗
妊娠结局
Early prereeclamsia
Low-molercular-weight heparin
Expectant management
Pregnancy outcome
