低分子肝素钠用于治疗复发性流产的效果观察
|
摘要
目的探讨低分子肝素钠治疗复发性流产的临床效果。方法选取2016年12月至2017年12月鄂东医疗集团黄石市妇幼保健院、鄂东医疗集团黄石市中心医院和湖北省妇幼保健院接受治疗的90例复发性流产患者作为研究对象。采用随机数字表法实施分组,对照组45例,给予常规治疗;观察组45例,在对照组基础上加用低分子肝素钠治疗。对两组患者治疗前后的各项临床指标、妊娠并发症发生情况以及不良反应发生情况进行综合评价。结果观察组患者治疗后的凝血酶原时间(PT)、凝血酶时间(TT)等水平均有所改善,显著优于对照组,差异具有统计学意义(P<0.05);观察组患者治疗后的妊娠并发症率为6.67%,与对照组对比差异具有统计学意义(P<0.05);且观察组治疗后有4例患者存在不良反应,占8.89%,显著低于对照组的26.67%,两组差异具有统计学意义(P<0.05)。结论低分子肝素钠治疗复发性流产,能够提升妊娠结局,促进患者各项指标改善,不良反应少,值得临床推广应用。
Objective To investigate the clinical effect of low molecular weight heparin sodium in the treatment of recurrent spontaneous abortion. Methods 90 patients with recurrent spontaneous abortion undergoing treatment in Huangshi Maternal and Child Health Care Hospital, Huangshi Central Hospital and Hubei Maternal and Child Health Hospital from December 2016 to December 2017 were selected as study subjects. The patients were divided into two groups according to random number table. The control group(n=45) was given routine treatment. The observation group(n=45) received low molecular weight heparin sodium treatment on the basis of routine treatment. Clinical indicators before and after treatment, pregnancy complications and adverse reactions of the two groups were comprehensively evaluated. Results After treatment, the prothrombin time(PT) and thrombin time(TT) in observation group improved significantly, which was significantly better than that in control group(P<0.05), with statistically significant differences. After treatment, incidence of pregnancy complications in the observation group was 6.67%,with statistically significant difference between the two groups(P<0.05).There were 4 cases of adverse reactionsin the observation group(8.89%), significantly lower than that of control group(26.67%), with statistically significant differences(P<0.05). Conclusions Low molecular weight heparin sodium treatment of recurrent spontaneous abortion, can improve pregnancy outcomes and the indicators of patients with few adverse reactions, which is worthy of clinical application.
Objective To investigate the clinical effect of low molecular weight heparin sodium in the treatment of recurrent spontaneous abortion. Methods 90 patients with recurrent spontaneous abortion undergoing treatment in Huangshi Maternal and Child Health Care Hospital, Huangshi Central Hospital and Hubei Maternal and Child Health Hospital from December 2016 to December 2017 were selected as study subjects. The patients were divided into two groups according to random number table. The control group(n=45) was given routine treatment. The observation group(n=45) received low molecular weight heparin sodium treatment on the basis of routine treatment. Clinical indicators before and after treatment, pregnancy complications and adverse reactions of the two groups were comprehensively evaluated. Results After treatment, the prothrombin time(PT) and thrombin time(TT) in observation group improved significantly, which was significantly better than that in control group(P<0.05), with statistically significant differences. After treatment, incidence of pregnancy complications in the observation group was 6.67%,with statistically significant difference between the two groups(P<0.05).There were 4 cases of adverse reactionsin the observation group(8.89%), significantly lower than that of control group(26.67%), with statistically significant differences(P<0.05). Conclusions Low molecular weight heparin sodium treatment of recurrent spontaneous abortion, can improve pregnancy outcomes and the indicators of patients with few adverse reactions, which is worthy of clinical application.
引文
[1] 张阳佳,朱宝生.复发性自然流产的病因学研究进展[J].中国妇幼保健,2015,30(10):1637-1640.
[2] 梁蓉,石通和,刘淑芳,等.阿司匹林联合低分子肝素治疗血栓前状态致早期复发性流产的效果评价[J].中国现代医生,2014,52(16):63-65.
[3] 邹琳,何红华,庞小艳,等.低分子肝素在人类辅助生殖技术获得妊娠后发生复发性流产患者中的临床研究[J].医学研究生学报,2017,30(4):399-404.
[4] Jong PGD,Kaorp S,Nisio MD,et al.ALIFE2 study:low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia-study protocol for a randomized controlled trial[J].Trials,2015,16(1):208-217.
[5] 王丹,潘长青,邓艳梅,等.叶酸联合低分子肝素和小剂量阿司匹林治疗复发性流产的临床研究[J].现代药物与临床,2017,32(9):1705-1709.
[6] 曲宇,黄林凤.低分子肝素钙与低分子右旋糖酐对脾切除断流术后门静脉血栓形成及血清D-二聚体水平的影响[J].现代中西医结合杂志,2017,26(1):91-93.
[7] 汪杰,黄官友,叶贵丹,等.低分子肝素钠治疗复发性流产对前置胎盘及早产的影响[J].实用妇产科杂志,2017,33(6):450-452.
[8] 邹琳,李洪波,彭彩玲,等.低分子肝素钠用于治疗D-二聚体异常升高复发性流产的临床观察[J].中国计划生育学杂志,2013,21(10):678-680.
[9] Chakraborty P,Banerjee S,Saha P,et al.Aspirin and Low-Molecular weight heparin combination therapy effectively prevents recurrent miscarriage in hyperhomocysteinemic women[J].Plos One,2013,8(9):e74155-e74161.
[10] 马斐飞.小剂量低分子肝素钙联合传统安胎法治疗D-D异常升高复发性流产的疗效观察[J].中国现代医生,2015,53(36):50-53.
[11] 胡利霞,涂雪松,陈玉环,等.血管生成素-2及其受体在子宫内膜异位症发生发展中的作用[J].中国性科学,2016,25(5):50-53.
[12] 益敏辉,张瑜,金志军.米非司酮对人子宫内膜细胞凋亡及促血管生成因子表达的影响[J].实用妇产科杂志,2016,32(7):523-527.
[13] 魏静波,刘辉,朱小茼,等.NK细胞和树突状细胞与药物流产后异常子宫出血的相关性研究[J].中国妇幼保健,2015,30(29):5015-5018.
[14] 邓婷,李晴,陈丹,等.铜/低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性[J].中国组织工程研究,2016,20(34):5057-5063.
[15] Cetin O,Karaman E,Cim N,et al.The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism[J].Ginekologia Polska,2017,88(5):260-265.
[2] 梁蓉,石通和,刘淑芳,等.阿司匹林联合低分子肝素治疗血栓前状态致早期复发性流产的效果评价[J].中国现代医生,2014,52(16):63-65.
[3] 邹琳,何红华,庞小艳,等.低分子肝素在人类辅助生殖技术获得妊娠后发生复发性流产患者中的临床研究[J].医学研究生学报,2017,30(4):399-404.
[4] Jong PGD,Kaorp S,Nisio MD,et al.ALIFE2 study:low-molecular-weight heparin for women with recurrent miscarriage and inherited thrombophilia-study protocol for a randomized controlled trial[J].Trials,2015,16(1):208-217.
[5] 王丹,潘长青,邓艳梅,等.叶酸联合低分子肝素和小剂量阿司匹林治疗复发性流产的临床研究[J].现代药物与临床,2017,32(9):1705-1709.
[6] 曲宇,黄林凤.低分子肝素钙与低分子右旋糖酐对脾切除断流术后门静脉血栓形成及血清D-二聚体水平的影响[J].现代中西医结合杂志,2017,26(1):91-93.
[7] 汪杰,黄官友,叶贵丹,等.低分子肝素钠治疗复发性流产对前置胎盘及早产的影响[J].实用妇产科杂志,2017,33(6):450-452.
[8] 邹琳,李洪波,彭彩玲,等.低分子肝素钠用于治疗D-二聚体异常升高复发性流产的临床观察[J].中国计划生育学杂志,2013,21(10):678-680.
[9] Chakraborty P,Banerjee S,Saha P,et al.Aspirin and Low-Molecular weight heparin combination therapy effectively prevents recurrent miscarriage in hyperhomocysteinemic women[J].Plos One,2013,8(9):e74155-e74161.
[10] 马斐飞.小剂量低分子肝素钙联合传统安胎法治疗D-D异常升高复发性流产的疗效观察[J].中国现代医生,2015,53(36):50-53.
[11] 胡利霞,涂雪松,陈玉环,等.血管生成素-2及其受体在子宫内膜异位症发生发展中的作用[J].中国性科学,2016,25(5):50-53.
[12] 益敏辉,张瑜,金志军.米非司酮对人子宫内膜细胞凋亡及促血管生成因子表达的影响[J].实用妇产科杂志,2016,32(7):523-527.
[13] 魏静波,刘辉,朱小茼,等.NK细胞和树突状细胞与药物流产后异常子宫出血的相关性研究[J].中国妇幼保健,2015,30(29):5015-5018.
[14] 邓婷,李晴,陈丹,等.铜/低密度聚乙烯复合材料宫内节育器引起子宫异常出血与铜离子浓度和血管生成的相关性[J].中国组织工程研究,2016,20(34):5057-5063.
[15] Cetin O,Karaman E,Cim N,et al.The impact of low molecular weight heparin on obstetric outcomes among unexplained recurrent miscarriages complicated with methylenetetrahydrofolate reductase gene polymorphism[J].Ginekologia Polska,2017,88(5):260-265.