硝酸甘油联合甲基多巴治疗重度子痫前期的效果研究

目的:探讨硝酸甘油联合甲基多巴治疗重度子痫前期的临床效果及对围产结局的影响。方法:选取2015年5月～2018年6月我院收治的重度子痫前期患者81例作为研究对象,根据患者入院先后顺序分为对照组(40例)和观察组(41例),对照组给予常规治疗,观察组在对照组的基础上给予硝酸甘油联合甲基多巴治疗。比较两组患者的临床治疗效果、治疗前后平均动脉压(MAP)、24h尿蛋白(24 pro)和心率(HR)水平的变化及围产结局。结果:治疗后,观察组患者的总有效率显著高于对照组(95.12%vs. 80%,P0.05),两组MAP、24 pro和HR水平均较治疗前显著下降,且观察组的MAP和24 pro水平显著低于对照组(P0.05);观察组患者的产后出血、胎盘早剥、胎儿窘迫和新生儿窒息的发生率显著低于对照组,自然分娩率显著高于对照组(P0.05),两组的低体重儿的发生率相比无统计学差异(P0.05)。结论:硝酸甘油联合甲基多巴可有效降低重度子痫前期患者的血压和24 pro水平,提高自然分娩率,改善围产结局,显著提高临床效果。

Effect of Nitroglycerine Combined with Methyldopa in the Treatment of Severe Preeclampsia

ABSTRACT Objective: To explore the clinical efficacy of nitroglycerine combined with methyldopa in the treatment of severe preeclampsia and its effect on the perinatal outcome. Methods: 81 cases of patients with severe preeclampsia admitted to our hospital from May 2015 to June 2018 were selected and divided into the control group(40 cases) and the observation group(41 cases) according to the sequence of admission. The control group was treated with routine treatment. The observation group was treated with nitroglycerin combined with methyldopa on the basis of control group. The treatment effect, changes of MAP, 24 pro and HR level before and afterand perinatal outcome were compared between the two groups. Results: The total efficiency of observation group was higher than that of the control group (95.12% vs. 80%, P<0.05), the MAP, 24 pro and HR levels of both groups were significantly decreased than those before treatment, and the MAP and 24 pro levels of observation group were significantly lower than those of the control group (P<0.05). The incidence of postpartum hemorrhage, placental abruption, fetal distress and neonatal asphyxia in the observation group was significantly lower than that of the control group, and the incidence of natural childbirth was significantly higher than that of the control group (P<0.05). Conclusion: The combination of nitroglycerin and methyldopa can effectively reduce blood pressure and 24 pro in patients with severe preeclampsia, increase the rate of natural childbirth, improve the perinatal outcomes and increase the efficiency of treatment.