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硫酸镁治疗重度子痫前期的前瞻性随机试验:以利尿作为临床参数确定产后治疗时长

A prospective randomized trial of magnesium sulfate in severe preeclampsia: use of diuresis as a clinical parameter to determine the duration of postpartum therapy.

作者信息

Fontenot M Todd, Lewis David F, Frederick J Brian, Wang Yuping, DeFranco Emily A, Groome Lynn J, Evans Arthur T

机构信息

Florida Perinatal Associates, Tampa, USA.

出版信息

Am J Obstet Gynecol. 2005 Jun;192(6):1788-93; discussion 1793-4. doi: 10.1016/j.ajog.2004.12.056.

Abstract

OBJECTIVE

The purpose of this study was to assess the use of the onset of diuresis in the determination of the duration of postpartum magnesium sulfate therapy among patients with severe preeclampsia.

STUDY DESIGN

A prospective randomized trial of postpartum therapy with magnesium sulfate was conducted. The control group received 24 hours of therapy, and the study group received therapy until the onset of diuresis (urine output >100 mL/hr for 2 consecutive hours). The Student t test, chi 2 test, and Fisher's exact test were used for analysis of data; a probability value of <.05 was considered statistically significant.

RESULTS

There were 50 patients in the control group and 48 patients in the study group. There was no difference in maternal demographic data, severe disease criteria, blood pressure, 24-hour postpartum urine output, or need for antihypertensive therapy. The study group had a significantly shorter duration of therapy, and no patient had eclampsia or required the re-initiation of therapy.

CONCLUSION

The use of the onset of diuresis in the postpartum period as the determinant clinical parameter for the discontinuation of magnesium sulfate in patients with severe preeclampsia was associated with no untoward outcomes or need for the re-initiation of treatment.

摘要

目的

本研究旨在评估利尿开始时间在确定重度子痫前期患者产后硫酸镁治疗持续时间中的应用。

研究设计

进行了一项硫酸镁产后治疗的前瞻性随机试验。对照组接受24小时治疗,研究组接受治疗直至利尿开始(尿量连续2小时>100 mL/小时)。采用Student t检验、卡方检验和Fisher精确检验进行数据分析;概率值<.05被认为具有统计学意义。

结果

对照组有50例患者,研究组有48例患者。产妇人口统计学数据、严重疾病标准、血压、产后24小时尿量或降压治疗需求方面无差异。研究组的治疗持续时间明显较短,且无患者发生子痫或需要重新开始治疗。

结论

将产后利尿开始时间作为重度子痫前期患者停用硫酸镁的决定性临床参数,未出现不良后果,也无需重新开始治疗。

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