摘要
目的探讨早发型重度子痫前期孕妇使用低分子肝素钠、小剂量阿司匹林联合治疗对凝血功能和妊娠结局的影响。方法将2019年6月—2021年12月本院收治的93例早发型重度子痫前期孕妇,按照奇偶数字法分为观察组和对照组,对照组46例予以小剂量阿司匹林治疗,观察组47例在对照组基础上予以低分子肝素钠治疗,观察2组孕妇血压和24 h尿蛋白定量、凝血功能、血流动力学、母体并发症以及新生儿不良结局。结果观察组舒张压(DP)、收缩压(SP)以及平均动脉压(MAP)、24 h尿蛋白定量低于对照组(P<0.05);观察组纤维蛋白原(FIB)、血小板计数(PLT)水平低于对照组,凝血活酶时间(APTT)、凝血酶原时间(PT)长于对照组(P<0.05);观察组子宫动脉舒张末期最大血流速率比值(S/D)、平均搏动指数(PI)、血流动力指数(RI)值低于对照组(P<0.05);观察组母体胎盘早剥发生率为0.00%,低于对照组的13.04%(χ^(2)=4.570,P<0.05);观察组产后出血发生率为4.26%,低于对照组的19.57%(χ^(2)=5.225,P<0.05),观察组早产、胎儿生长受限发生率分别为4.26%、2.13%,低于对照组的21.74%、17.39%(χ^(2)=6.323、4.573,P均<0.05)。结论低分子肝素钠联合小剂量阿司匹林治疗早发型重度子痫前期孕妇有助于改善凝血功能,降低血压,减少蛋白尿,增加子宫供血,降低母体并发症和新生儿不良结局的发生率。
Objective To investigate the effect of combination therapy with low molecular weight heparin and low-dose aspirin on coagulation function and pregnancy outcomes in pregnant women with early-onset severe preeclampsia.Methods From June 2019 to December 2021,93 pregnant women with early-onset severe preeclampsia admitted to our hospital were divided into an observation group and a control group according to the random number table method,46 cases in the control group were treated with low-dose aspirin,47 cases in the observation group were treated with low molecular weight heparin on the basis of the control group.Blood pressure and 24-hour urine protein quantification,coagulation function,hemodynamics,maternal complications,and neonatal adverse outcomes were observed in the two groups.Results The diastolic blood pressure(DP),systolic blood pressure(SP),mean arterial pressure(MAP),and 24-hour urine protein quantification in the observation group were lower than those in the control group(P<0.05),and the levels of fibrinogen(FIB)and platelet count(PLT)in the observation group were lower than those in the control group,but thromboplastin time(APTT)and prothrombin time(PT)in the observation group were longer than those in the control group(P<0.05).The maximum blood flow rate ratio(S/D),mean pulsatile index(PI),and hemodynamic index(HI)values in the observation group were lower than those in the control group(P<0.05).The incidence of maternal placental abruption in the observation group was 0.00%,which was lower than that in the control group(13.04%)(χ^(2)=4.570,P<0.05).The incidence of postpartum hemorrhage in the observation group was 4.26%,which was lower than that in the control group(19.57%)(χ^(2)=5.225,P<0.05),and the incidence of preterm birth and fetal growth restriction in the observation group was 4.26%and 2.13%,respectively,which was lower than that in the control group(21.74%and 17.39%)(χ^(2)=6.323 and 4.573,both P<0.05).Conclusion Low molecular weight heparin combined with low-dose aspirin in the treatment of pregnant women with early-onset severe preeclampsia can help improve coagulation function,lower blood pressure,reduce proteinuria,increase uterine blood supply,and reduce the incidence of maternal complications and neonatal adverse outcomes.
作者
何芳
刘红阁
张雪芹
HE Fang;LIU Hongge;ZHANG Xueqin(Department of Obstetrics and Gynecology,Anyang People’s Hospital,Anyang 455000,Henan,China)
出处
《中国校医》
2024年第2期134-137,共4页
Chinese Journal of School Doctor
关键词
早发型重度子痫前期
低分子肝素钠
阿司匹林
凝血功能
妊娠结局
Early-onset severe preeclampsia
Low molecular weight heparin
Aspirin
Coagulation function
Pregnancy outcome
