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目的:探讨应用硫酸镁和拉贝洛尔联合治疗早发型重度子痫前期的效果,观察并分析其并发症及母婴预后状况,为临床治疗提供依据。方法:选择214例早发型重度子痫前期患者,根据治疗方案将所有患者随机分为对照组与观察组,每组107例,对照组给予硫酸镁治疗,观察组在对照组治疗基础上应用拉贝洛尔治疗。观察两组患者血压、并发症及围生儿结局情况。结果:观察组治疗后1 h平均收缩压为(144.92±6.83)mmHg,对照组为(50.03±7.15)mmHg,两组比较,差异有统计学意义(P<0.05)。观察组患者治疗后4小时收缩压[(135.09±4.53)mmHg]和舒张压[(84.12±1.94)mmHg]均低于对照组,两组比较,差异有统计学意义(P<0.05)。两组治疗后4小时平均收缩压和舒张压均低于治疗后1小时,两组比较,差异有统计学意义(P<0.05)。观察组患者治疗期间平均24小时蛋白尿为(1.79±0.16)g,对照组为(2.03±0.17)g,两组比较,差异有统计学意义(P<0.05)。观察组孕妇分娩前胎儿缺氧5例(4.67%)、肝肾能损害4例(3.73%)和胎盘早剥2例(1.87%),均低于对照组,两组比较,差异有统计学意义(P<0.05)。观察组胎儿评分为(9.26±0.19)分,高于对照组,两组比较,差异有统计学意义(P<0.05)。观察组新生儿窒息15例(14.02%),早产儿16例(18.18%),均低于对照组,两组比较,差异有统计学意义(P<0.05);观察组Apgar评分为(9.20±0.16)分,高于对照组,两组比较,差异有统计学意义(P<0.05)。结论:硫酸镁联合拉贝洛尔治疗子痫前期可有效降低孕妇血压,改善患者预后和母婴结局。
Objective: To investigate the effect of combined application of magnesium sulfate and labetalol in the treatment of early-onset severe preeclampsia, to observe and analyze its complications and the prognosis of maternal and infant, so as to provide the basis for clinical treatment. Methods: A total of 214 patients with early-onset severe preeclampsia were selected. All patients were randomly divided into control group and observation group according to treatment regimen, 107 cases in each group. The control group was treated with magnesium sulfate. The observation group was applied on the basis of the control group Bello treatment. Two groups of patients were observed blood pressure, complications and perinatal outcome. Results: The mean systolic blood pressure at 1 hour after treatment was (144.92 ± 6.83) mmHg in the observation group and (50.03 ± 7.15) mmHg in the control group. The difference was statistically significant (P <0.05). Systolic blood pressure (135.09 ± 4.53) mmHg and diastolic blood pressure (84.12 ± 1.94) mmHg in observation group were lower than those in control group at 4 hours after treatment. There was significant difference between the two groups (P <0.05). The average systolic and diastolic blood pressures at 4 hours after treatment in both groups were lower than those at 1 hour after treatment. There was significant difference between the two groups (P <0.05). The mean 24-hour proteinuria in the observation group was (1.79 ± 0.16) g during the treatment period, and (2.03 ± 0.17) g in the control group. There was significant difference between the two groups (P <0.05). In the observation group, fetus hypoxia before delivery was found in 5 cases (4.67%), liver and kidney damage in 4 cases (3.73%) and placental abruption in 2 cases (1.87%), both of which were lower than the control group Significance (P <0.05). The fetus score of the observation group was (9.26 ± 0.19) points, which was higher than that of the control group. There was significant difference between the two groups (P <0.05). There were 15 cases (14.02%) of neonatal asphyxia and 16 (18.18%) premature infants in the observation group, which were all lower than the control group (P <0.05). The Apgar score of the observation group was (9.20 ± 0.16), higher than the control group, the difference between the two groups was statistically significant (P <0.05). Conclusion: Magnesium sulfate combined with labetalol in preeclampsia can effectively reduce the blood pressure of pregnant women and improve the prognosis and maternal-infant outcome.