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目的探讨小剂量低分子肝素联合泼尼松治疗复发性流产的临床疗效。方法收集自2005年1月～2009年6月我院诊治的复发性流产患者42例,随机分为治疗组(22例)和对照组(20例)。治疗组患者妊娠后立即给予低分子肝素皮下注射,5 000 U/次,每日1次,同时口服泼尼松,5 mg/次,每日1次;对照组患者妊娠后立即给予黄体酮肌肉注射,20 mg/次,每日1次,同时肌肉注射绒毛膜促性腺激素,2 000 U/次,每日1次,两组患者疗程均为12周。全部患者在妊娠期间均给予叶酸、维生素E等基础治疗,妊娠结束后评价全部患者的临床疗效。结果治疗组患者妊娠有效率为81.8%,显著高于对照组的妊娠有效率(35.0%);而治疗组患者妊娠并发症发生率为13.6%,显著低于对照组(45.0%)。结论小剂量低分子肝素联合泼尼松治疗复发性流产的妊娠成功率高、妊娠并发症少、无严重不良反应,值得临床推广应用。
Objective To investigate the clinical efficacy of low-dose low molecular weight heparin combined with prednisone in the treatment of recurrent spontaneous abortion. Methods Twenty-two patients with recurrent spontaneous abortion diagnosed and treated in our hospital from January 2005 to June 2009 were randomly divided into treatment group (n = 22) and control group (n = 20). Patients in the treatment group were injected subcutaneously with LMWH subcutaneously immediately after pregnancy at 5 000 U once per day, while prednisone was given orally at 5 mg once daily. Patients in the control group were given progesterone immediately after pregnancy Injection, 20 mg / time, once daily, while intramuscular injection of human chorionic gonadotropin, 2 000 U / time, once daily, two groups of patients were treated for 12 weeks. All patients were given folic acid, vitamin E and other basic treatment during pregnancy, after the end of pregnancy to evaluate the clinical efficacy of all patients. Results The effective rate of pregnancy in the treatment group was 81.8%, which was significantly higher than that in the control group (35.0%). The incidence of pregnancy complications in the treatment group was 13.6%, which was significantly lower than that in the control group (45.0%). Conclusion Low-dose low molecular weight heparin combined with prednisone in the treatment of recurrent spontaneous abortion has a high success rate of pregnancy, fewer complications of pregnancy and no serious adverse reactions, which deserves clinical application.