解痉抗凝治疗早发型子痫前期的临床疗效观察

目的 探讨硫酸镁联合低分子量肝素与丹参解痉抗凝治疗早发型子痫前期的临床效果及安全性.方法 选取孕26 ～ 34周早发型子痫前期患者103例,按随机数字表法分为A组（硫酸镁治疗组）34例,B组（硫酸镁＋低分子量肝素治疗组）36例,C组（硫酸镁＋低分子量肝素＋丹参治疗组）33例,比较三组治疗前后24 h尿蛋白及凝血指标,分娩情况及新生儿出生情况等.结果 三组入院时24h尿蛋白及各凝血指标比较差异均无统计学意义（P＞0.05）;分娩前A、B、C组24 h尿蛋白分别为（5.38±0.32）,（4.96±0.22）和（4.31 ±0.26） g/24 h,A组显著高于B、C组,差异有统计学意义（P＜0.05）;A、B、C组活化部分凝血活酶时间（APTT）分别为（31.45±5.71）,（33.34±5.96）和（38.12±3.49）s,C组较A、B组显著延长,差异有统计学意义（P＜0.05）,其他凝血指标比较差异无统计学意义（P＞0.05）.A、B、C组延长孕周时间分别为（6.40±3.46）,（10.70±4.21）和（12.50±3.73）d,差异有统计学意义（P＜0.05）;三组患者并发症发生情况比较差异无统计学意义（P＞0.05）.三组新生儿体质量比较差异无统计学意义（P＞0.05）;A、B、C组新生儿窒息率分别为29.4％（10/34）,19.4％（7/36）和6.1％（2/33）,C组低于A、B组,差异有统计学意义（P＜0.05）;而三组新生儿病死率比较差异无统计学意义（P＞0.05）.结论 硫酸镁联合低分子量肝素与丹参治疗早发型子痫前期能有效控制24h尿蛋白,改善凝血功能,有效延长孕周,改善新生儿预后.

The curative effect of spasmolysis and anticoagulant therapy in early onset pre-eclampsia

Objective To analyze the curative effect and safety of spasmolysis and anticoagulant therapy in early onset pre-eclampsia. Methods One hundred and three patients with early onset pre-eclampsia at 26 - 34 weeks of gestational age were enrolled in this study, and they were divided into A group （magnesium sulfate treatment group, 34 cases） and B group （magnesium sulfate ＋ low molecular heparin treatment group, 36 cases） and C group （magnesium sulfate ＋ low molecular heparin ＋ salvia miltiorrhiza treatment group, 33 cases） by random digits table method. The coagulation function, 24 h urine protein, pregnancy outcomes and neonatal situations were measured and compared among three groups. Results The coagulation function index and 24 h urine protein among three groups had no significant difference （P 〉 0.05 ）. The level of 24 h urine protein in A, B, C group prior to delivery was （5.38 ± 0.32）, （4.96 ± 0.22） and （4.31 ± 0.26） g/24 h. The level of 24 h urine protein in A group was significantly higher than that in B group and C group （P 〈 0.05 ）. The level of activated partial thromboplastin time （APTF） in A, B,C group was （31.45 ± 5.71 ）, （33.34 ±5.96） and （38.12 ± 3.49） s. The level of APTT in C group was significantly longer than that in A group and B group（P 〈 0.05 ）. The level of other coagulation function index was no significant difference （P 〉 0.05 ）. The time of prolonged gestational age of A, B, C group was（6.40 ± 3.46）, （ 10.70 ± 4.21 ） and（ 12.50 ± 3.73 ） d respectively, and there was no significant difference （P 〈 0.05 ）. The rate of complication among three groups had no significant difference （P 〉 0.05 ）. The body weight of neonate among three groups had no significant difference （P〉 0.05）. The rate of neonatal asphyxia in A, B, C group was 29.4% （ 10/34 ）, 19.4% （7/36） and 6.1% （2/33） respectively, and the rate of neonatal asphyxia in C group was signifieandy higher than that in A group and B group （P〈 0.05）. The fatality rate of neonate among three groups had no significant difference （P 〉 0.05）. Conclusion Magnesium sulfate combined with low molecular heparin and salvia miltiorrhiza can control 24 h urine protein, improve the coagulation function, also can prolong the gestational age and improve neonatal prognosis of early onset pre-eelampsia.