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截至 2 0 0 2年 8月 ,有关妊娠子痫及高血压的临床证据如下 :预防 :①抗血小板药物 :1个系统评价发现 ,对可能发生先兆子痫的孕妇使用抗血小板药物 (主要是阿司匹林 )与使用安慰剂或不治疗相比 ,在降低发生先兆子痫的危险、减少胎儿死亡和早产方面有统计学意义 ,在其他重要结局上无统计学意义。随后的 1个小样本随机对照试验 (RCT)也得出相似的结论。该系统评价还发现 ,无证据表明使用阿司匹林会比安慰剂增加孕妇或胎儿出血的危险。②补钙 (用于高危孕妇或钙摄入不足的孕妇 ) :1个系统评价发现 ,给孕妇补钙 ( 2g/d)与使用安慰剂相比 ,在降低先兆子痫的发病危险及减少胎儿出生时体重不足 2 5 0 0g方面有统计学意义 ,但对降低死产、住院期间围产儿死亡、减少剖腹产或早产没有统计学意义。③补镁 :1个系统评价发现 ,尚无充足证据证明补镁对有发生先兆子痫或其并发症危险的孕妇有效。④其它药物干预 :两个RCT比较了使用阿替洛伟或硝酸甘油与安慰剂 ,但由于纳入的病例数太少不能得出可靠结论。⑤限制盐的摄入 :1个系统评价的有限证据表明 ,低盐饮食与正常饮食相比 ,在降低孕妇先兆子痫的发生率方面无统计学差异。⑥VitC和VitE :在高危孕妇中进行的 1个RCT中 ,有限的证据显示 ,使用VitC和VitE与安慰剂相比 ,前
As of August 2002, the clinical evidence for eclampsia and hypertension in pregnancy is as follows: Prevention: ① anti-platelet drugs: a systematic review found that anti-platelet drugs (mainly aspirin ) Was statistically significant in reducing the risk of developing preeclampsia, reducing fetal death and premature birth compared with placebo or no treatment, with no other significant outcome. A subsequent small sample randomized controlled trial (RCT) also reached similar conclusions. The systematic review also found no evidence that aspirin use increases the risk of bleeding in pregnant women or fetuses than placebo. Calcium supplementation (for high-risk pregnant women or inadequate intake of calcium in pregnant women): a systematic review found that giving pregnant women calcium (2g / d) compared with placebo, reducing the risk of pre-eclampsia and reduce the fetus Birth weight less than 2500g was statistically significant, but to reduce stillbirth, perinatal mortality during hospitalization, reduce caesarean section or preterm birth was not statistically significant. ③ Magnesium supplementation: 1 systematic review found that there is no sufficient evidence that magnesium supplementation is effective for pregnant women who have pre-eclampsia or their risk of complications. Other drug interventions: Two RCTs compared atelovic or nitroglycerin with placebo, but the number of included cases did not lead to reliable conclusions. Limiting Salt Intake: There is limited evidence from a systematic review that there is no statistical difference in the incidence of pre-eclampsia among pregnant women when compared with the normal diet. ⑥ VitC and VitE: There is limited evidence in 1 RCT performed in high-risk pregnant women showing that before using VitC and VitE compared with placebo,