低分子肝素治疗胎儿生长受限的临床效果分析(1)
【摘要】 目的：观察低分子肝素(LMWH)治疗胎儿生长受限(FGR)的效果及对围生儿结局的影响。方法：选取2016年2月-2018年1月笔者所在医院产科收治的FGR病例96例，随机分为研究组和对照组，每组48例。对照组采用静脉滴注低分子右旋糖酐、复方氨基酸常规治疗，研究组在对照组治疗的基础上使用LMWH治疗，对两组胎儿的生长发育情况、治疗前后羊水指数(AFI)、脐动脉血流阻力(S/D比值)、新生儿发育情况，以及治疗前后产妇血小板计数、凝血功能指标变化进行综合对比。结果：治疗后研究组的平均每个疗程宫高及胎儿生长参数的增长值均明显高于对照组，AFI增加及脐动脉S/D比值下降明显优于对照组，差异有统计学意义(P<0.05)。研究组新生儿出生后身长、胎龄、体重、1 min Apgar评分均优于对照组，差异有统计学意义(P<0.05)。研究组和对照组新生儿窒息率分别为6.25%、20.83%，差异有统计学意义(P<0.05)。LMWH治疗前后产妇血小板计数、凝血功能指标无明显改变，差异无统计学意义(P>0.05)。结论：在常规治疗基础上，用LMWH治疗FGR能有效改善子宮胎盘血液循环，增加胎盘血液灌注，促进胎儿生长发育，降低新生儿窒息发生率，改善妊娠结局，且无凝血功能异常改变，值得临床推广应用。
【关键词】 低分子肝素; 胎儿生长受限; 新生儿窒息; 临床疗效
doi：10.14033/j.cnki.cfmr.2019.02.004 文献标识码 A 文章编号 1674-6805(2019)02-000-03
Clinical Analysis of Low Molecular Weight Heparin in the Treatment of Fetal Growth Restriction/MEI Yaoling.//Chinese and Foreign Medical Research，2019，17(2)：-10
【Abstract】 Objective：To observe the effect of Low Molecular Weight Heparin(LMWH) on fetal growth restriction (FGR) and it’s effect on perinatal outcomes.Method：From February 2016 to January 2018，96 cases of FGR admitted to our department of obstetrics were randomly divided into the study group and the control group，with 48 cases in each group.The control group was treated with intravenous infusion of Low Molecular Weight Dextran and Compound Amino Acids.The study group was treated with LMWH on the basis of treatment in the control group.The growth and development of the two groups of fetuses，the amniotic fluid index(AFI) before and after treatment，and the umbilical artery blood flow resistance(S/D ratio)，neonatal development，and maternal platelet count and coagulation function before and after treatment were comprehensively compared.Result：The mean uterine height and the increase of fetal growth parameters in each course of treatment in the study group were significantly higher than those in the control group.The increase of AFI and decrease of umbilical artery S/D ratio in the study group were significantly better than the control group，the differences were statistically significant(P<0.05).The Apgar score at 1 minute，gestational age，body weight and length of the study group were better than those of the control group after birth(P<0.05).The neonatal asphyxia rate in the study group and the control group was 6.25% and 20.83% respectively，the difference was statistically significant(P<0.05).There were no significant changes in platelet count and coagulation function before and after treatment in the LMWH groups，and the differences were not statistically significant(P>0.05).Conclusion：On the basis of routine treatment，LMWH can effectively improve the uteroplacental blood circulation，increase placental blood perfusion，promote fetal growth and development，reduce the incidence of neonatal asphyxia，improve pregnancy outcome，and no abnormal coagulation changes，it is worthy of clinical promotion and application., http://www.100md.com(梅耀玲)
【关键词】 低分子肝素; 胎儿生长受限; 新生儿窒息; 临床疗效
doi：10.14033/j.cnki.cfmr.2019.02.004 文献标识码 A 文章编号 1674-6805(2019)02-000-03
Clinical Analysis of Low Molecular Weight Heparin in the Treatment of Fetal Growth Restriction/MEI Yaoling.//Chinese and Foreign Medical Research，2019，17(2)：-10
【Abstract】 Objective：To observe the effect of Low Molecular Weight Heparin(LMWH) on fetal growth restriction (FGR) and it’s effect on perinatal outcomes.Method：From February 2016 to January 2018，96 cases of FGR admitted to our department of obstetrics were randomly divided into the study group and the control group，with 48 cases in each group.The control group was treated with intravenous infusion of Low Molecular Weight Dextran and Compound Amino Acids.The study group was treated with LMWH on the basis of treatment in the control group.The growth and development of the two groups of fetuses，the amniotic fluid index(AFI) before and after treatment，and the umbilical artery blood flow resistance(S/D ratio)，neonatal development，and maternal platelet count and coagulation function before and after treatment were comprehensively compared.Result：The mean uterine height and the increase of fetal growth parameters in each course of treatment in the study group were significantly higher than those in the control group.The increase of AFI and decrease of umbilical artery S/D ratio in the study group were significantly better than the control group，the differences were statistically significant(P<0.05).The Apgar score at 1 minute，gestational age，body weight and length of the study group were better than those of the control group after birth(P<0.05).The neonatal asphyxia rate in the study group and the control group was 6.25% and 20.83% respectively，the difference was statistically significant(P<0.05).There were no significant changes in platelet count and coagulation function before and after treatment in the LMWH groups，and the differences were not statistically significant(P>0.05).Conclusion：On the basis of routine treatment，LMWH can effectively improve the uteroplacental blood circulation，increase placental blood perfusion，promote fetal growth and development，reduce the incidence of neonatal asphyxia，improve pregnancy outcome，and no abnormal coagulation changes，it is worthy of clinical promotion and application., http://www.100md.com(梅耀玲)