Chen F P, Chang S D, Chu K K
Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Taiwan, R.O.C.
Acta Obstet Gynecol Scand. 1995 Mar;74(3):181-5. doi: 10.3109/00016349509008935.
Although magnesium sulfate has been traditional or standard treatment for severe preeclampsia and eclampsia to prevent convulsions, its efficiency has always been in doubt and its induced side-effects also make it controversial for use. In this study, 64 patients, diagnosed with severe preeclampsia, were randomized into group I (34 patients) managed with MgSO4, and group II (30 patients) managed without MgSO4. There were no occurrences of eclampsia in either group. Although there was no statistical significance in the final delivery method, group I had a higher rate in cesarean section, in which most were significantly due to fetal distress (p < 0.05). Furthermore, group I had significantly more babies with poor apgar score than group II (p = 0.019). During the treatment period for those with a gestational age of less than 34 weeks, there were two patients with abruptio placentae in group I and the treatment periods were noted to be longer in group II than in group I. From the results of monitoring serum magnesium level in group I, when therapeutic level was achieved, magnesium sulfate induced great discomfort which might have led to the deterioration of the patients' condition. According to this study, magnesium sulfate's minimal efficiency, and its adverse side-effects, also make magnesium sulfate a poor choice in the management of preeclampsia. Therefore, because of our poor understanding of the etiology of preeclampsia, suitable management should be undertaken without magnesium sulfate. Improvement of the patient's pathophysiological condition or termination of pregnancy as early as possible, is recommended.
尽管硫酸镁一直是治疗重度子痫前期和子痫以预防惊厥的传统或标准疗法，但其疗效一直受到质疑，而且其引发的副作用也使其在使用上存在争议。在本研究中，64例被诊断为重度子痫前期的患者被随机分为两组，第一组（34例患者）采用硫酸镁治疗，第二组（30例患者）不采用硫酸镁治疗。两组均未发生子痫。虽然最终分娩方式无统计学差异，但第一组剖宫产率较高，其中大多数明显是由于胎儿窘迫（p<0.05）。此外，第一组阿氏评分低的婴儿明显多于第二组（p = 0.019）。在孕周小于34周的患者治疗期间，第一组有2例胎盘早剥患者，且第二组的治疗时间比第一组长。从第一组血清镁水平监测结果来看，当达到治疗水平时，硫酸镁会引起极大不适，这可能导致患者病情恶化。根据本研究，硫酸镁疗效甚微且有不良副作用，这也使其成为子痫前期治疗的不佳选择。因此，由于我们对子痫前期病因了解不足，应在不使用硫酸镁的情况下进行适当治疗。建议改善患者的病理生理状况或尽早终止妊娠。
