目的研究低分子肝素与常规方法结合对早发型重度子痫前期患者凝血功能、肾功能、肝功能、妊娠结局的影响。方法 2012年3月至2013年12月就诊46例早发型重度子痫前期患者,按随机数字表法分为观察组23例(联合治疗)和对照组(常规治疗)23例。观察两组患者的血压,对比治疗前后的尿蛋白、凝血功能、肾功能、肝功能及妊娠结局,评价治疗效果。结果 (1)治疗后,两组平均动脉压、每日尿量、ALT、AST、红细胞比容均较治疗前改善(P<0.05或P<0.01);且观察组平均动脉压、ALT、AST、红细胞比容较对照组改善更明显(P<0.05或P<0.01)。24 h尿蛋白无明显变化,与对照组相近(P>0.05)。(2)凝血指标中PLT、PT、APTT、TT观察组较对照组显著升高或延长(P均<0.05);D-二聚体、FIB两组间比较无统计学差异(P均>0.05)。(3)观察组分娩孕周较对照组明显推迟(P<0.05),孕周延长时间长于对照组(P<0.05)。两组围产儿死亡率、孕产妇死亡率及分娩方式差异无统计学意义(P均>0.05)。(4)观察组与对照组比较产后出血量并未增加(P>0.05)。结论应用低分子肝素治疗早发型重度子痫前期患者可缓解血液高凝状态,改善患者平均动脉压、尿量、肝功能及红细胞比容,延长孕周,不增加产后出血量,临床有效。 Objective To investigate the effect of low molecular weight heparin combined with routine methods on coagulation, renal function, liver function and pregnancy outcomes in patients with preeclais severe preeclampsia. Methods From March 2012 to December 2013, 46 patients with early-onset severe preeclampsia were divided into observation group (23 cases) and control group (23 cases) by random number table. The blood pressure of the two groups was observed. The urine protein, coagulation, renal function, liver function and pregnancy outcome were compared before and after treatment to evaluate the therapeutic effect. Results After treatment, mean arterial pressure, daily urine output, ALT, AST and hematocrit in both groups were significantly improved compared with before treatment (P <0.05 or P <0.01); mean arterial pressure, ALT, AST , Hematocrit improved more significantly than the control group (P <0.05 or P <0.01). 24 h urinary protein no significant change, similar to the control group (P> 0.05). (2) Compared with control group, the levels of PLT, PT, APTT and TT in coagulation index increased significantly (P <0.05); there was no significant difference between D-dimer and FIB ). (3) The gestational age of the observation group was significantly delayed than that of the control group (P <0.05), and the prolonged gestational weeks were longer than the control group (P <0.05). There was no significant difference in perinatal mortality rate, maternal mortality rate and delivery mode between the two groups (all P> 0.05). (4) Compared with the control group, the observation group did not increase postpartum hemorrhage (P> 0.05). Conclusions The application of low molecular weight heparin in early-onset severe preeclampsia can relieve the blood hypercoagulability, improve the average arterial pressure, urine volume, liver function and hematocrit in patients with prolonged gestational age without increasing the amount of postpartum hemorrhage, which is clinically effective.