低分子肝素钠治疗胎儿生长受限的临床研究(1)
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[摘要] 目的 探讨低分子肝素钠治疗胎儿生长受限的临床效果及安全性。方法 选择56例FGR孕妇随机分为A组和B组各28例，A组给予低分子肝素钠治疗，B组给予低分子右旋糖酐加丹参治疗，对合并有子痫前期的孕妇同时给予解痉降压治疗。结果 A组与B组在宫高、胎儿双顶径、股骨长、头围腹围、脐血流S/D值、羊水指数改变、胎儿生物物理评分、新生儿体重和新生儿窒息率的比较差异均有统计学意义(P<0.05)；两组治疗前后血小板计数和凝血功能指标进行比较，差异无统计学意义(P>0.05)。 结论 低分子肝素钠有助于改善FGR孕妇的治疗效果，且对母亲和胎儿安全性均较好。
[关键词] 低分子肝素；低分子右旋糖酐；丹参；FGR；新生儿体重
[中图分类号] R714.5 [文献标识码] B [文章编号] 1673-9701(2011)33-59-02
Clinical Study of Low Molecular Weight Heparin in Treatment of Fetal Growth Restriction
ZHU Qinghua WU Wenxue HAN Qingping
Department of Obstetrics and Gynecology, the People's Hospital of Pingyang County in Zhejiang Province, Pingyang 325400, China
[Abstract] Objective To evaluate the clinical efficacy and safety of low molecular weight heparin in treatment of fetal growth restriction. Methods All 56 pregnant women with FGR were randomly divided into group A and group B, with 28 cases in each. Group A received low molecular weight heparin, and group B received low molecular weight dextran Salvia miltiorrhiza treatment. The pregnant women with preeclampsia were given antispasmodic and antihypertensive treatment. Results The height of the uterus, fetal biparietal diameter, femur length, head circumference, abdominal circumference, umbilical S/D values, changes in the amniotic fluid index, fetal biophysical score, birth weight, neonatal asphyxia of group A and group B were different (P<0.05). Platelet count and coagulation parameters of before and after treatment were not significant different (P>0.05). Conclusion The low molecular weight heparin helps to improve outcomes of patients with FGR. The low molecular weight heparin has good safety for the mother and fetus.
[Key words] Low molecular heparin; Low molecular dextran; Salvia miltiorrhiza; FGR; Neonatal weight
胎儿生长受限(fetal growth restriction，FGR)是严重威胁胎儿发育质量及远期影响儿童和青春期的智能、体能发育的产科并发症[1]，其病因复杂，与胎盘血流灌注不足、遗传、感染、内分泌等多方面因素有关[2]，目前临床上常用补充氨基酸、输注低分子右旋糖酐加丹参来治疗，但疗效甚微。我院通过使用低分子肝素钠改善胎盘血流灌注治疗FGR，取得良好效果，现报道如下。
1 资料与方法
1.1 一般资料
选择2007年4月～2009年12月在我院定期产前检查并在我院分娩且确诊为FGR的孕妇56例。诊断标准依据乐杰主编的《妇产科学》(第7版)[3]中的相关标准，患者符合诊断后，根据知情同意的原则，自愿加入研究组，排除标准：①有明确的低分子肝素过敏史或过敏体质者；②患出血性疾病者；③肝功能异常者；④预期24h内手术或分娩者。根据进入研究的先后顺序随机将患者分为两组，两组孕妇年龄、孕周、胎次、妊娠合并症比较差异无统计学意义(P>0 ......
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