Clinical efficacy of hyperbaric oxygen combined with magnesium sulfate in the treatment of gestational hypertension and analysis of influencing factors of adverse pregnancy outcomes
Objective To investigate the clinical efficacy of hyperbaric oxygen combined with magnesium sulfate in the treatment of gestational hypertension,and to analyze the influencing factors of adverse pregnancy outcomes.Methods A total of 93 pregnant women with gestational hypertension admitted to the Liaocheng Second People's Hospital from October 2020 to July 2023 were prospectively selected as the study objects,and divided into group A(n=48)and group B(n=45)according to their treatment methods.Adverse pregnancy outcomes were divided into occurrence group(n=23)and non-occurrence group(n=70).Group A was treated with hyperbaric oxygen combined with magnesium sulfate,while group B was treated with magnesium sulfate only.The clinical efficacy and adverse pregnancy outcomes of the two groups were observed,and the related influencing factors of adverse pregnancy outcomes were analyzed.Results The total effective rate of clinical treatment in group A(93.75％)was higher than that in group B(75.56％),and the difference was statistically significant(P＜0.05).After 7 days of treatment,plasma vascular endothelial growth factor(VEGF)and thromboxane A2(TXA2)levels in both groups were significantly lower than before,and plasma prostacyclin(PGI2)level was significantly higher than before;compared with group B,plasma VEGF and TXA2 levels in group A were significantly lowered,while plasma PG12 level were significantly increased,with statistically significant differences(P＜0.001).Levels of prothrombin time(PT)and activated partial thromboplastin time(APTT)after 7 days of treatment were significantly higher than before in both groups,with level of plasma PAI-1 being significantly lowered,and the plasma tissue-type plasminogen activator(t-PA)level after 7 days in group A was significantly higher than that before treatment.Compared with group B,the levels of PT,APTT,and plasma t-PA in group A were increased,while level of plasma plasminogen activator inhibitor-1(PAI-1)was lowered,with statistically significant differences(P＜0.05 or P＜0.001).The main suspected influencing factors for adverse pregnancy outcomes were the severity of the disease,the gestational week of onset,combined with hypothyroidism,the levels of plasma VEGF,PG12,and TXA2 levels before treatment,PT and APTT before treatment,and plasma t-PA and PAI-1 levels before treatment(P＜0.05).Severe disease,onset of the disease at＜28 weeks of gestation,combined with hypothyroidism,and elevated VEGF level before treatment were the main influencing factors leading to the occurrence of adverse pregnancy outcomes(P＜0.05).Conclusion Hyperbaric oxygen combined with magnesium sulfate has better clinical efficacy on gestational hypertension,improving patients'vascular endothelial function and coagulation and fibrinolysis functions.Severe disease,onset of the disease at＜28 weeks of gestation,combined with hypothyroidism,and elevated VEGF level before treatment were the main influencing factors leading to the occurrence of adverse pregnancy outcomes.
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