小剂量阿司匹林联合低分子肝素治疗妊娠高血压临床疗效

周德霞

[摘要] 目的 探討小剂量阿司匹林联合低分子肝素对妊娠高血压的疗效。 方法 选择2018年1月至2019年12月本院收治的妊娠高血压患者100例，依据随机数字表法分为对照组（低分子肝素）与观察组（于对照组基础上加以小剂量的阿司匹林），每组各50例，比较两组治疗前后的血压水平、有效率、妊娠结局、终止妊娠孕龄及新生儿体重情况。 结果 治疗后，观察组收缩压及舒张压为（128.65±12.74）mmHg、（85.16±4.26）mmHg，低于对照组的（139.28±16.50）mmHg、（94.18±5.62）mmHg（P<0.05）。观察组的总有效率（96.00%）高于对照组（78.00%）（P<0.05）。观察组自然分娩率为42.00%，高于对照组的20.00%，剖宫产率为58.00%，低于对照组的80.00%，不良妊娠结局发生率为4.00%，低于对照组的40.00%（P<0.05）。观察组终止妊娠孕龄为（38.95±1.15）周，长于对照组的（36.45±1.08）周，新生儿体重为（2692.45±125.48）g，高于对照组的（2310.32±118.56）g（P<0.05）。 结论 予以妊娠高血压患者小剂量的阿司匹林和低分子肝素疗效确切，能降低患者的血压水平，改善其妊娠结局，延长其孕龄，增加胎儿出生体重，值得临床应用。

[关键词] 妊娠高血压;低分子肝素;阿司匹林;小剂量;妊娠结局;终止妊娠

[中图分类号] R714.2          [文献标识码] B          [文章编号] 1673-9701（2021）09-0089-03

Clinical effect of low-dose aspirin combined low molecular weight heparin on treatment of gestational hypertension

ZHOU Dexia

Department of Internal Medicine， Nantong City Maternal And Child Health Hospital in Jiangsu Province， Nantong 226000， China

[Abstract] Objective To explore the therapeutic efficacy of low-dose aspirin combined with low molecular weight heparin in the treatment of pregnancy induced hypertension. Methods A total of 100 patients with pregnancy induced hypertension admitted to our hospital from January 2018 to December 2019 were selected for research. And they were divided into the control group（n=50， treated with low molecular weight heparin） and the observation group（n = 50，treated with low-dose aspirin based on the control group） according to the random number table method. The blood pressure level， efficacy rate， pregnancy outcome， gestational weeks of termination and neonatal weight were counted and compared between the two groups before and after treatment. Results After treatment， the systolic and diastolic blood pressures in the observation group were （128.65±12.74） mmHg and （85.16±4.26） mmHg， lower than （139.28±16.50） mmHg and （94.18±5.62） mmHg in the control group （P<0.05）. The total efficacy rate of the observation group was 96.00%， significantly higher than 78.00% of the control group（P<0.05）. The natural delivery rate in the observation group was 42.00%， higher than 20.00% in the control group. The cesarean section rate was 58.00%，lower than 80.00% in the control group. And the incidence of adverse pregnancy outcomes was 4.00%，significantly lower than 40.00% in the control group（P<0.05）. The termination of pregnancy gestational age of the observation group was （38.95±1.15） weeks， longer than （36.45±1.08） weeks of the control group， and the neonatal weight of the observation group was（2692.45±125.48） g， greater than （2310.32±118.56） g of the control group（P<0.05）. Conclusion Low-dose aspirin and low molecular weight heparin are effective in patients with pregnancy induced hypertension， and they can reduce the blood pressure level of patients， improve pregnancy outcome， prolong gestational weeks and increase the neonatal weight， which are worthy of application.

[Key words] Pregnancy induced hypertension; Low molecular weight heparin; Aspirin; Low-dose; Pregnancy outcome; Termination of pregnancy

妊娠高血压是妊娠期妇女一类特有的疾病，多出现于妊娠20周以后[1]。据有关资料显示[2]，妊娠高血压患病率在5%～12%，该病的发生主要与全身的细小动脉痉挛，引发内皮损伤进而导致局部缺血有关，主要表现为高血压、水肿和蛋白尿等，分娩后症状可消失，严重者可产生抽搐、脏器功能衰竭和昏迷等情况，威胁到母婴健康，是造成不良妊娠结局甚至母婴死亡的主要原因之一。因此，尽早确诊疾病后予以进一步治疗对保障母婴安全意义重大。低分子肝素属于普通肝素研制而成的一类葡萄胺聚糖，是当前公认的一种妊娠期高血压有效治疗药物，然而单一用药效果欠佳。近年来研究发现[3]，除低分子肝素外加以小剂量的阿司匹林能提升妊娠高血压患者疗效。为此，现对2018年1月至2019年12月本院收治的妊娠高血压患者共100例开展研究，分析小剂量的阿司匹林联合低分子肝素对该类患者的疗效，现报道如下。……