氨氯地平联合硫酸镁治疗妊娠期高血压的疗效观察

目的观察氨氯地平联合硫酸镁治疗妊娠期高血压的临床疗效。方法选取2012年4月—2015年6月福建省龙岩市第二医院收治的妊娠期高血压患者100例,随机分为对照组和治疗组,每组各50例。对照组静脉滴注硫酸镁注射液20 m L加入到5%葡萄糖溶液100 m L,0.5 h内滴注完毕,继而以硫酸镁注射液60 m L加入5%葡萄糖溶液1 000 m L中静脉滴注9 h。治疗组在对照组的治疗基础上加用苯磺酸氨氯地平片,10 mg/次,1次/d。两组患者持续服药,血压降到治疗目标且稳定后要对患者持续治疗,直到妊娠结束。观察两组的临床疗效和妊娠结局,观察两组治疗前后的血压变化。结果治疗后,对照组和治疗组的总有效率分别为68.0%、90.0%,两组比较差异有统计学意义(P0.05)。治疗后,两组收缩压和舒张压均显著降低,同组治疗前后差异有统计学意义(P0.05);治疗后治疗组的下降程度优于对照组,两组比较差异具有统计学意义(P0.05)。治疗组在产后出血、早产、胎盘早剥、新生儿呼吸窘迫、新生儿死亡方面均低于对照组,两组比较差异具有统计学意义(P0.05)。结论氨氯地平联合硫酸镁治疗妊娠期高血压疗效较好,可显著降低患者的血压,改善妊娠结局,具有一定的临床推广应用价值。

Clinical observation of amlodipine combined with magnesium sulfate in treatment of gestational hypertension

Objective To observe the clinical effect of amlodipine combined with magnesium sulfate in treatment of gestational hypertension. Methods Patients (100 cases) with gestational hypertension in the Second Hospital of Longyan from April 2012 to June 2015 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were iv administered with Magnesium Sulfate Injection, 20 mL Magnesium Sulfate Injection added into 5% glucose solution 100 mL, which finished within 0.5 h. And then they were iv administered with Magnesium Sulfate Injection 60 mL added into 5% glucose solution 1000 mL in 9 h. The patients in treatment group were po administered with Amlodipine Besylate Tablets, 10 mg/time, once daily. When blood pressure descended to the target, patients in two groups were accepted continuous treatment until the end of the pregnancy. After treatment, the efficacy and pregnancy outcomes were evaluated, and the changes of blood pressure in two groups were compared before and after treatment. Results After treatment, the efficacies in the control and treatment groups were 68.0% and 90.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, systolic and diastolic blood pressures in two groups were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). These observational indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). The incidence of postpartum hemorrhage, premature labor, placental abruption, neonatal respiratory distress, and neonatal death were lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Amlodipine combined with magnesium sulfate has clinical curative effect in treatment of gestational hypertension, and can significantly reduce the blood pressure, also can improve the pregnancy outcome, which has a certain clinical application value.