摘要
目的旨在观察小剂量阿司匹林联合低分子量肝素对血栓前状态复发性流产患者凝血功能的影响,并探讨对妊娠结局的改善作用,为临床治疗提供参考。方法选取2019-02-01-2020-12-20开封市妇产医院治疗的复发性流产孕妇126例,采用组间匹配的方法分为对照组与观察组,每组63例。对照组给予小剂量阿司匹林治疗,75 mg/次,1次/d,连续服用至20周;观察组在对照组基础上加用低分子量肝素钠,5000 IU/次,1次/d,维持治疗至妊娠12周;观察2组凝血功能指标、妊娠结局及不良反应,使用SPSS 22.0进行分析,计量资料组间均数比较采用t检验;计数资料组间率比较采用χ^(2)检验。结果治疗后观察组D-二聚体(D-D)(110.24±11.53)μg/L低于对照组(130.01±10.27)μg/L,差异有统计学意义,t=10.163,P<0.001;观察组凝血酶时间(TT)(17.73±1.00)s高于对照组TT(16.98±2.03)s,差异有统计学意义,t=2.631,P=0.010;观察组抗凝血酶Ⅲ(AT-Ⅲ)(113.27±13.45)mg/L高于对照组AT-Ⅲ(95.41±15.37)mg/L,差异有统计学意义,t=6.941,P<0.001;观察组流产率7.94%低于对照组25.40%,差异有统计学意义,χ^(2)=6.914,P=0.009;观察组活产率87.30%高于对照组66.67%,差异有统计学意义,χ^(2)=7.570,P=0.006;对照组不良反应总发生率30.16%与观察组33.33%比较,差异无统计学意义,χ^(2)=0.147,P=0.702。结论小剂量阿司匹林联合低分子量肝素治疗血栓前状态复发性流产可改善凝血功能,降低流产率,提升活产率,改善妊娠结局,且具有较高的安全性。
Objective To observe the effect of low-dose aspirin combined with low molecular weight heparin on the coagulation function of patients with prethrombotic recurrent miscarriage,discuss the improvement effect on pregnancy outcome,and provide reference for clinical treatment.Methods A total of 126 pregnant women with recurrent miscarriage treated in the Kaifeng Maternity Hospital from 2019-02-01 to 2020-12-20 were divided into a control group and a study group with 63 cases in each group using the method of matching between groups.The control group was treated with low-dose aspirin,75 mg/time,1 time/d,for continuous use up to 20 weeks;the observation group was treated with low-molecular-weight heparin sodium,5,000 IU/time,1 time/d,maintained treatment on the basis of the control group to 12 weeks of pregnancy;coagulation function indexes,pregnancy outcome and adverse reactions in the two groups were observed,SPSS 22.0 was used for analysis,the t test was used for the comparison of the mean between the measurement data groups;2 test was used to perform the comparison of the rate between the count data groups.Results After treatment,D-dimer(DD)of the observation group(110.24±11.53)μg/L was lower than that of the control group(130.01±10.27)μg/L,the difference was statistically significant(t=10.163,P<0.001);thrombin time(TT)and antithrombinⅢ(AT-Ⅲ)of the observation group(17.73±1.00)s,(113.27±13.45)mg/L were higher than those of the control group(16.98±2.03)s,(95.41±15.37)mg/L,the difference was statistically significant(t=2.631,P=0.010;t=6.941,P<0.001);The abortion rate of the observation group was 7.94%lower than that of the control group 25.40%,the difference was statistically significant(χ^(2)=6.914,P=0.009);the live birth rate of the observation group was 87.30%higher than that of the control group 66.67%,the difference was statistically significant(χ^(2)=7.570,P=0.006);the total incidence of adverse reactions in the control group was 30.16%compared with 33.33%in the observation group,the difference was not statistically significant(χ^(2)=0.147,P=0.702).Conclusions The combination of low-dose aspirin and low-molecularweight heparin in the treatment of prethrombotic recurrent miscarriage can improve blood coagulation,reduce the rate of miscarriage,increase the rate of live births,improve the outcome of pregnancy,and has high safety.
作者
薛傲霜
李冬玲
李晶晶
XUE Ao-shuang;LI Dong-ling;LI Jing-jing(Kaifeng maternity Hospital,Kaifeng 475000,China)
出处
《社区医学杂志》
CAS
2022年第15期857-860,共4页
Journal Of Community Medicine
关键词
血栓前状态
阿司匹林
低分子量肝素
复发性流产
凝血功能
prethrombotic state
aspirin
low molecular weight heparin
recurrent abortion
coagulation function
作者简介
通信作者:薛傲霜,女,河南开封人,主管药师,主要从事医院药事管理的研究工作。E-mail:1301110717@qq.com
