黄体酮配合白蛋白治疗重度妊娠高血压综合征的临床效果观察

目的:探讨黄体酮配合白蛋白对重度妊娠高血压综合征的治疗效果,为临床用药提供依据。方法:将87例重度妊娠高血压综合征孕妇随机分为两组,在综合治疗的基础上,观察组肌注黄体酮配合静滴白蛋白,对照组单纯静滴白蛋白,观察两组临床症状及体征改善情况、孕龄延长情况、经阴道分娩率、不良反应发生率、孕产妇及围产儿结局、产后泌乳情况等。结果:①两种处置方法在改善临床症状、体征上均有一定的作用,但观察组优于对照组,尤其是在稳定血压和缓解呼吸上两组相比有极显著性差异(P<0.01);在消退腹水及增加尿量上两组相比有显著性差异(P<0.05)。②观察组在延长孕龄、经阴道分娩率上均高于对照组,两组比较有极显著性差异(P<0.01)。③不良反应少。④无孕产妇死亡,围产儿死亡3例,其中观察组1例,对照组2例。⑤对产后泌乳无影响。结论:黄体酮配合白蛋白治疗重度妊娠高血压综合征疗效确切,可在临床推广应用。

Observation on clinical effect of progestin and albumin on severe pregnant induced hypertension

Objective:To explore the clinical effect of progestin and albumin on severe pregnant induced hypertension (PIH) and to provide the evidence for clinical drug administration.Methods:87 severe PIH patients were randomly divided into observation group (except for general treatment, injected intramuscularly progestin and intravenous bolus of albumin) and control group (given intravenous bolus of albumin).The clinical symptoms, signs, pregnant duration, delivery rate by vagina, adverse effect, outcome of pregnant and fetus and postpartum milk secretion in two groups were observed. Results:①The clinical symptoms and signs in two groups were improved, but the effect in observation group was better than that of control group, especially blood pressure stabilization and respiratory remission with greatly significant difference (P<0.01).There were significant difference in ascites subsiding and urinary volume increase between two groups (P<0.01).②The pregnant duration prolonging and rate of delivery by vagina in observation group were higher than those of controls (P<0.01).③Adverse effect was less.④No death case was found in pregnant and lying-in women.Of 3 perineonates died, there was 1 case in observation group, the other 2 ones were in control group.⑤No effect was found on postpartum milk secretion.Conclusion:Progestin and albumin have definite therapeutic effect on treatment of severe PIH, which could be spread in clinic.