低分子肝素联合静脉补液治疗羊水过少的临床疗效

目的：观察低分子肝素联合静脉补液治疗羊水过少的疗效及安全性。方法：回顾性分析2008年3月至2011年10月本院收治的93例羊水过少患者的临床资料。48例治疗组患者应用低分子肝素联合静脉补液治疗；45例对照组患者应用丹参联合静脉补液治疗,7 d为1个疗程,比较两组治疗前后羊水指数（ AFI）、相关凝血指标、剖宫产率、新生儿窒息率及产后出血量等指标。结果：治疗组未发生因使用肝素所致的产后出血、血肿、皮肤黏膜出血及过敏反应等。对照组和治疗组治疗后的AFI均较治疗前升高（P〈0.05）,其中治疗组治疗后AFI高于对照组（P〈0.05）。两组患者治疗前后PLT、PT、APTT、TT和FIB比较,差异均无统计学意义（均P〉0.05）。治疗组新生儿窒息率、剖宫产率均明显低于对照组（ P〈0.05）；两组产后出血量比较,差异无统计学意义（ P〉0.05）。结论：低分子肝素联合静脉补液是治疗妊娠晚期羊水过少安全、有效方法,可改善妊娠结局。

Clinical efficacy of low molecular weight heparin combined with intravenous rehydration on oligohydramnios

Objective：To observe the efficacy and safety of low molecular weight heparin （ LMWP ） combined with intravenous rehydration on oligohydramnios. Methods： The clinical data of 93 patients with oligohydramnios admitted in our hospital from March 2008 to October 2011 were retrospectively analyzed. 48 patients in the treatment group were treated by low molecular weight heparin combined with intravenous rehydration; 45 patients in the control group were treated by salvia miltiorrhiza combined with intravenous rehydration, 7 days as 1 course. Amnionic fluid index （AFI）, related coagulogram markers, percentages of cesarean section, neonatal asphyxia rate and postpartum hemorrhage volume, etc. were compared before and after treatment between the two groups. Results： In the treatment group, there was no postpartum hemorrhage, hematoma, mucocutaneous hemorrhage and anaphylactic reaction, etc caused by the using of heparin. After treatment, the average increasing volume of AFI in both of the control group and the treatment group increased than before treatment. And the AFI of the treatment was significantly higher than in control group （P〈0.05）. There was no statistical significance of PLT, PT, APTT, TT and FIB between before and after treatment of the two groups （ P〉0.05） . The rates of neonatal asphyxia and caesarean section were significantly lower in treatment group than in control group （ P〈0.05） . There was no significant difference in blood coagulation indication before and after treatment between the two groups （ P〉0. 05 ） . Conclusion：LMWP combined with intravenous rehydration was a safe and effective method to treat oligoamnios of late trimester of pregnancy, and could improve pregnancy outcome.