参照不同标准调整硫酸镁滴速治疗妊娠期高血压效果观察

目的观察参照不同标准调整硫酸镁滴速治疗妊娠期高血压(pregnancy induced hypertension,PIH)的临床效果。方法选择2011年1月—2013年1月收治的PIH患者110例,随机分为对照组和观察组各55例,两组均采用硫酸镁进行常规治疗,所有患者均使用WZ-50型微量泵输注硫酸镁,给予25%硫酸镁60 ml加入5%葡萄糖注射液500 ml静脉滴注,滴速1² g/h,每日总量252 g/h,每日总量25³0 g。对照组硫酸镁滴速标准采用传统标准执行,观察组在传统标准的基础上,同时根据患者的临床治疗反应进行调整,主要观察指标包括皮肤潮红、出汗、口干、恶心、呕吐、心慌、头晕、全身肌肉酸痛、浑身无力,如出现上述不适,不直接停药,而是慢慢调低硫酸镁滴速,直至不出现或仅出现轻微不适。以血压稳定或降低,未更换硫酸镁治疗为有效,比较两组疗效、血压情况及不良反应发生率。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果对照组有效率为83.64%;观察组有效率为100.00%,两组比较差异有统计学意义(t=7.745,P<0.05)。治疗后对照组和观察组收缩压分别为(146.4±10.2)(140.5±10.7)mm Hg(1 mm Hg=0.133 kPa),舒张压分别为(98.8±9.3)、(90.1±9.1)mm Hg,两组收缩压和舒张压比较差异均有统计学意义(t=2.819、4.737,均P<0.05)。不良反应发生率对照组为28.26%,观察组为1.82%,两组比较差异有统计学意义(χ2=4.466,P<0.05)。结论治疗PIH时,以患者的临床治疗反应为标准调节硫酸镁滴速,疗效较好,不良反应小。

Magnesium sulfate drip rate adjustment according to different standards in PHI

Objective To observe the clinical efficacy of pregnancy induced hypertension （PIH） treated by magnesium sulfate at different drip rates adjusted by different standards.Methods 110 cases of PIH treated from January 2011 to January 2013 were randomly divided into control group and observation group,Fifty-five cases for each group. Both groups were treated with magnesium sulfate conventionally, magnesium sulfate micro-pumps and micro-needles were used in all patients, 60 ml of 25% magnesium sulfate was given intravenously in mixture with 500 ml of 5% glucose solution, the drip rate was 1-2 g/h and the daily dose was 25-30 g.In control group, magnesium sulfate was given at a standard drip rate; in observation group the drip rate of magnesium sulfate was adjusted according to the patient＇s clinical response, such as skin flushing, sweating,dry mouth,nausea,vomlting, palpitation, dizziness, aching muscles and feeling weak. If the above symptoms developed, magnesium sulfate should be given at a lower drip rate until they disappeared or become less rather than abandoned promptly. Stable or low blood pressure without dis- continuance of magnesium sulfate was considered to be effective. Both groups were compared for clinical efficacy, blood pressure and the incidence of adverse reactions. Two-sample t test was used for measurement data and χ2 test for count data groups, the result of P〈0.05 was considered to be statistically significant.Results The effective rate was 83.64% in control group and 100.00% in observation group was, the difference was statistically significant （χ2 = 7.745,P〈0.05）. After treatment, systolic blood pressure was （146.4 ± 10.2） mm Hg（1 mm Hg=0.j33 kPa） in control group and （140.5 ± 10.7） mm Hg in observation group; diastolic blood pressure was（146.4 ± 10.2） mm Hg in control group and（140.5 ± 10.7）ram Hg in observation group, and there was significant difference between the two groups （χ2 = 2.819,4.737,P〈0.05）. The incidence of adverse reactions was 28.26% in control group and 1.82% in observation group, the difference was statistically significant （χ2 = 4.466,P〈0.05）. Conclusion For PIH, magnesium sulfate drip rate adjustment according to the patient＇s clinical response is of better efficacy, less adverse reactions, and worthy of promotion.