摘要
目的探讨中西医结合治疗与护理干预对妊娠期肝内胆汁淤积症肝功能、血流变学、凝血功能及炎性因子的影响。方法妊娠肝内胆汁淤积症96例,随机分为两组,对照组31例,观察组65例,两组一般资料比较,P>0.05。选择正常妊娠孕妇50例为正常对照组。对照组基本治疗加熊去氧胆酸,常规护理。观察组在对照组的基础上加用清热解毒、保肝利胆、活血化瘀中草药,日一剂,水煎服。两组均治疗两周。治疗前与治疗两周后抽取晨起静脉血检测肝功能、血流变学、凝血功能、D-二聚体、炎性因子等。应用SPSS20.0软件,所获数据采用方差分析、t检验和2检验。结果两组治疗前与正常对照组肝功能变化比较,P均>0.05;对照组治疗前后肝功能变化比较,P均<0.0005;观察组治疗前后肝功能变化比较,P均<0.0005;两组治疗前后肝功能变化比较,P均<0.0005。两组治疗前与正常对照组血流变学变化比较,P均<0.00005。两组治疗前血流变学变化比较,P均>0.05。对照组治疗前后全血黏度高切、红细胞压积、血沉变化比较,P均<0.00005;对照组治疗前后全血黏度低切变化比较,P>0.05;对照组治疗前后血浆黏度变化比较,P<0.05。观察组治疗前后血流变学变化比较,P均<0.0005。两组治疗后全血黏度高切、血浆黏度变化比较,P>0.05;两组治疗后全血黏度低切、红细胞压积变化比较,P均<0.01;两组治疗后血沉变化比较,P<0.005。两组治疗前与正常对照组凝血指标变化比较,P均<0.01~0.0005。两组治疗前凝血指标变化比较,P>0.05。对照组治疗前后PLT比较,P<0.0005;对照组治疗前后FIB比较,P<0.05;对照组治疗前后PT、APTT变化比较,P>0.05。观察组治疗前后PLT、FIB变化比较,P均<0.0005;观察组治疗前后PT变化比较,P<0.01;观察组治疗前后APTT变化比较,P<0.005。两组治疗后PLT变化比较,P<0.01;两组治疗后FIB、PT变化比较,P均<0.05;两组治疗后APTT变化比较,P>0.05。两组治疗前与正常对照组炎性因子及D-二聚体水平比较,P均<0.0005。两组治疗前炎性因子及D-二聚体水平比较,P>0.05。对照组治疗前后炎性因子及D-二聚体水平比较,P均<0.0005。观察组治疗前后炎性因子及D-二聚体水平比较,P均<0.0005。两组治疗后炎性因子水平比较,P<0.0005;两组治疗后D-二聚体水平比较,P<0.05。对照组痊愈4例,占12.90%;显效9例,占29.03%;总有效率77.42%。观察组痊愈20例,占30.77%;显效26例,占40.00%;总有效率98.46%。结论中西医结合治疗与护理干预妊娠肝内胆汁淤积症能更大程度的减轻症状和体征、保护胎儿降低早产率、窒息率、死亡率,对母婴无明显的副作用。
Objective To discuss the cooperation of Chinese and western medicine therapy and nursing intervention of gestation intrahepatic cholestasis disease of liver function, hemorrheology and coagulation function and inflammatory factor influence. Methods 96 cases were randomly divided into two groups, compared to the control group, the control group was 65, and the comparison of the two groups was P〉0.05. In addition, 50 cases of normal pregnant women were chosen as normal control group. The control group treated the bear deoxycholic acid. Routine nursing. The observa- tion group, based on the control group, was used to detoxify, hepatobiliary, and blood stasis, and a daily dose of water de- coction. Both groups were treated for two weeks. After two weeks before the treatment, the blood tests were taken： liver function, blood rheology, coagulant function, d-dimer, inflammatory factor, etc. Using SPSS20.0 software, the data obtained using variance analysis, t test and X2 test. Results Compared with normal control liver function, P averaged 〉 0.05. The comparison of liver function in the control group was 〈 0.0005. The comparison of liver function before and after treatment was observed, and P was 〈 0.0005. Both groups were compared before and after treatment, and the P was 〈 0.0005. Compared with the normal control group, the P was 〈 0.00005. The two groups were compared to the changes in blood theology, and the P was 〉 0.05. In the control group, the ratio of full-blood viscosity, erythrocyte and hematogenous changes were compared, and P was 〈 0.00005. The control group was treated with a lower and lower blood viscosity change compared to P〉0.05. The comparison of plasma viscosity changes in the control group was P〈0.05. The comparison of blood rheological changes before and after treatment was 〈 0.0005. The two groups were treated with high blood viscosity and plasma viscosity changes, and P〉0.05. The two groups were compared with the lower blood viscosity and the variation of red blood cell pressure. The comparison of the two groups of treatments was compared with the comparison of the two groups with the normal control group of the control group, which was 〈 0.01-0.0005. The comparison of the two groups of precurable blood markers was P〉0.05. The control group compared the PLT before and after treatment, P〈 0.0005. The control group was treated before and after the FIB comparison, P〈0.05. The control group treatment was compared to PT and APTT, P〉0.05. Before and after group therapy, the PLT and FIB changes were compared, and P was 〈 0.0005. The comparison of the PT changes before and after treatment was observed, P〈0.01. The APTT comparison was observed before and after treatment, and P〈0.005. After two groups of treatment, PLT changes compared to P〈0.01. After two groups of treatment, FIB and PT were compared with P〈0.05. After treatment, APTT was compared, P〉0.05. Both groups were compared with normal control inflammatory factors and d-dimer levels, and P was 〈 0.0005. The two groups were compared to the preinflammatory factor and the d-dimer level, P〉0.05. The comparison of inflammatory factors and d-dimer levels in the control group was 〈 0.0005. The comparison of the inflammatory factors and the level of d-dimer was observed in the observation group, P〈0.0005. The levels of inflammatory factors were compared after two groups of treatment, P〈0.0005. The two groups were compared with the d-dimer, P〈0.05. The control group recovered 4 cases, accounting for 12.90 percent. In 9 cases, 29.03%. Total efficiency 77.42%. The observation group recovered 20 cases, accounting for 30.77%. In 26 cases, 40.00%. Total efficiency 98.46%. Conclusion Combine traditional Chinese and western medicine therapy and nursing intervention in intrahepatic cholestasis of pregnancy disease can reduce the signs and symptoms, greater protection of fetus to reduce the rate of premature birth, asphyxia rate, mortality rate, the maternal and infant has no obvious side effects.
出处
《菏泽医学专科学校学报》
2017年第3期80-84,共5页
Journal of Heze Medical College
关键词
妊娠
肝内胆汁淤积症/治疗
肝内胆汁淤积症/护理
中西医结合疗法/治疗应用
血流变学
凝血功能
炎性因子
Pregnancy
Intrahepatic cholestasis of pregnancy/therapy
Intrahepatic cholestasis of pregnancy/nursing
Chinese and western medicine combination therapy/therapeutic sue
Hemorrheology
Blood coagulation function
Inflammatory cytokines
