硫酸镁治疗轻度子痫前期的临床效果评价

目的 探讨硫酸镁在治疗轻度子痫前期中的意义及对妊娠结局的影响.方法 将2008年～2012年在我院诊断为轻度子痫前期的605例患者分为硫酸镁治疗组（300例）和临床观察组（305例）,比较两组发生重度子痫前期、胎儿窘迫、胎儿生长受限、新生儿窒息、产后出血以及终止妊娠孕周和方式.结果 硫酸镁治疗组有45例（15%）、临床观察组有52例（17%）发展为重度子痫前期.两组重度子痫前期、胎儿窘迫、胎儿生长受限、新生儿窒息及产后出血的发生率无统计学意义.两组无1例发生子痫,无孕产妇及围生儿死亡.硫酸镁治疗组有4例发生硫酸镁严重毒副反应导致急性左心衰、肺水肿.结论 硫酸镁不能阻断轻度子痫前期病情的发展及改变妊娠结局,且可能增加不良反应.对轻度子痫前期的患者进行镇静、降压治疗并严密监测血压、尿蛋白、眼底血管痉挛情况及孕妇的自觉症状,适时终止妊娠是安全可行的.

The therapeutic effect of magnesium sulfate for mild preeclampsia

Objective To explore the therapeutic effect of magnesium sulfate for mild ＂preeclampsia and its impacts on pregnancy outcome. Methods 605 women with mild preeclampsia were randomly divided into two groups; experimental group treated with intravenous magnesium sulfate （ n = 300） and controlled group （n = 305 ） . The outcome measures such as rates of severe preeclampsia, fetal distress, fetal growth restriction, neonatal asphyxia and postpartum hemorrhage, gestational weeks of pregnancy termination, rate of cesarean section were compared between two groups. Results Forty-five women （15%） in experimental group and 52 （17% ） in controlled group developed severe preeclampsia. There was no significance difference in rates of severe preeclampsia, fetal distress, fetal growth restriction, neonatal asphyxia, postpartum hemorrhage between two groups. There was no case of eclampsia or perinatal infant death. Four patients in experimental group had serious side effects-acute left heart failure and pulmonary edema. Conclusion Magnesium sulfate can not prevent the progression to severe preeclampsia or improve pregnancy outcome. Sedative treatment and close monitoring of blood pressure, urine protein, retinal vascular spasm and complaints of pregnant women is safe and feasible for patients with mild preeclampsia.