| 摘要: |
| ［摘要］ 目的 观察复合维生素联合低分子量肝素和小剂量阿司匹林预防子痫前期的临床疗效及安全性。方法 选取该院2016-01～2016-12收治的子痫前期高危孕妇330例，年龄19～45（26.3±4.4）岁，孕周12～16（14.3±2.1）周。采用随机双盲法将患者分为对照组、二联组（低分子肝素联合小剂量阿司匹林）和三联组（复合维生素联合低分子肝素和小剂量阿司匹林），每组110例。对照组按常规处理。二联组为睡前口服阿司匹林75 mg/次，1次/d至孕36周，皮下注射那曲肝素钙4 100 U/次，1次/d至终止妊娠前24 h。三联组在二联组的基础上睡前口服复合维生素片1片/次，1次/d至分娩。观察比较各组血小板计数、部分凝血活酶时间（APTT）、子痫前期及不良妊娠结局（流产、早产、胎盘早剥、胎儿生长受限、新生儿窒息、围生儿死亡以及产后出血）发生率。结果 与对照组比较，治疗后二联组和三联组APTT明显延长（P<0.05）。二联组和三联组孕妇轻度子痫前期的发生率显著低于对照组（P<0.05），但三组孕妇重度子痫前期的发生率比较差异无统计学意义（P>0.05）。二联组和三联组孕妇胎盘早剥、胎儿生长受限及新生儿窒息发生率均显著低于对照组（P<0.05）。三组孕妇治疗后流产、早产、围生儿死亡及产后出血发生率比较，差异无统计学意义（P>0.05）。结论 孕早期应用复合维生素联合低分子肝素和小剂量阿司匹林可显著降低高危孕妇子痫前期和不良妊娠结局发生率，并不增加产后出血发生风险，提示上述联合用药具有较好的临床疗效及较高安全性。 |
| 关键词: 复合维生素 低分子量肝素 阿司匹林 子痫前期 疗效 安全性 |
| DOI：10.3969/j.issn.1674-3806.2019.08.15 |
| 分类号:R 711 |
| 基金项目: |
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| Clinical efficacy of compound vitamin combined with low molecular weight heparin and low dose aspirin for preeclampsia |
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LÜ Jun, SHAN Rui-qin, YANG Qiu-hong, et al.
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Department of Gynaecology and Obstetrics, Ji′nan Maternal and Child Health Care Hospital, Shandong 250001, China
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| Abstract: |
| ［Abstract］ Objective To observe the clinical efficacy and safety of compound vitamin combined with low molecular weight heparin(LMWH) and low dose aspirin(LDA) for preeclampsia. Methods Three hundred and thirty pregnant women with high-risk preeclampsia were collected in Ji′nan Maternal and Child Health Care Hospital from January 2016 to December 2016. The ages of the patients were 19～45 years old with an average of (26.3±4.4)years, and the gestational weeks were 12～16 weeks with an average of (14.3±2.1)weeks. The patients were divided into three groups using the randomized double blind method, including control group(n=110), bigeminy group(treated with LMWH in combination with LDA)(n=110) and trigeminy group(treated with compound vitamin combined with LMWH and LDA)(n=110). The control group received conventional treatment. The bigeminy group was subcutaneously injected with nadroparin calcium 4100 U every time per day until 24 hours before termination and received aspirin(75 mg every time per day) by oral administration until 36 weeks of gestation. The trigeminy group received the same treatment as the bigeminy group plus oral administration of compound vitamin 1 tablet every time per day until delivery. The indicators, including platelet count, activated partial thromboplastin time(APTT), incidence of preeclampsia and adverse pregnancy outcomes(abortion, preterm labor, placental abruption, fetal growth restriction, neonatal asphyxia, perinatal death, and postpartum hemorrhage) were observed and compared among the three groups. Results The APTT in the bigeminy group and the trigeminy group was significantly longer than that in the control group(P<0.05). The incidence of mild preeclampsia in the bigeminal group and the trigeminy group was significantly lower than that in the control group(P<0.05). There were no statistically significant differences in the incidence rates of severe preclampsia among the three groups(P>0.05). The incidence rates of placental abruption, fetal growth restriction and neonatal asphyxia in the bigeminy group and the trigeminy group were significantly lower than those in the control group(P<0.05). There were no statistically significant differences in the incidence rates of abortion, preterm labor, perinatal death and postpartum hemorrhage among the three groups（P>0.05）. Conclusion Early treatment of compound vitamin combined with LMWH and LDA can significantly reduce the incidence of preeclampsia in high-risk pregnant women, and decrease the incidence of adverse pregnancy outcomes, but does not increase the risk of postpartum hemorrhage, indicating that compound vitamin combined with LMWH and LDA has better clinical curative effect and high safety. |
| Key words: Compound vitamin Low molecular weight heparin(LMWH) Aspirin Preeclampsia Curative effect Safety |
