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目的探讨低分子肝素治疗早发型重度子痫前期对母婴预后的影响。方法:选择2011年1月～12月恩施州巴东人民医院收治的早发型重度子痫前期患者112例,按随机数字表法分为观察组和对照组,每组56例。对照组给予常规治疗,观察组在此基础上加用低分子肝素。比较两组24 h尿量、24 h尿蛋白定量、PLT、PT、Fib、DD、HCT及孕周延长时间、围产儿结局和产妇并发症。结果:两组治疗后24 h尿量、24 h尿蛋白定量均显著改善(P<0.05),观察组明显优于对照组(P<0.05);两组PLT、PT、Fib治疗前后均无明显变化(P>0.05),观察组DD、HCT降低(P<0.05),且明显低于对照组(P<0.05);两组孕产妇并发症和围产儿不良结局发生率均有统计学差异(P<0.05);观察组孕周延长(10.7±1.9)天,对照组孕周延长(4.6±1.7)天,两组孕周差异有统计学意义(P<0.05)。结论:低分子肝素治疗早发型重度子痫前期能有效抑制高凝状态,改善肾功能,延长孕周时间,改善母婴预后,值得临床推广应用。
Objective To investigate the effect of low molecular weight heparin on prognosis of early-onset severe preeclampsia. Methods: A total of 112 patients with early-onset severe preeclampsia admitted to Badong People’s Hospital of Enshi from January to December 2011 were randomly divided into observation group and control group with 56 cases in each group. Control group given conventional treatment, the observation group on the basis of the addition of low molecular weight heparin. The 24-hour urine output, 24-hour urinary protein, PLT, PT, Fib, DD, HCT, gestational age prolongation, perinatal outcome and maternal complications were compared between the two groups. Results: The urinary output, 24 h urinary protein in 24 hours after treatment were significantly improved (P <0.05), and the observation group was significantly better than the control group (P <0.05). There was no significant difference between the two groups before and after treatment of PLT, PT, Fib (P <0.05). DD and HCT in the observation group decreased (P <0.05), and were significantly lower than those in the control group (P <0.05). The incidences of maternal complications and perinatal adverse outcomes were significantly different between the two groups P <0.05). The gestational age in the observation group was prolonged (10.7 ± 1.9 days), and the gestational age in the control group was prolonged (4.6 ± 1.7 days). There was significant difference in gestational age between the two groups (P <0.05). Conclusion: Low molecular weight heparin treatment of early-onset severe preeclampsia can effectively inhibit the hypercoagulable state, improve renal function, prolong the gestational age and improve the prognosis of maternal and infant, worthy of clinical application.