低分子肝素治疗胎儿生长受限的临床研究

目的:观察低分子肝素对胎儿生长受限的治疗效果。方法:64例胎儿生长受限患者分为治疗组和对照组,每组32人,治疗组应用低分子右旋糖酐加低分子肝素治疗,对照组应用低分子右旋糖酐加丹参治疗,7天为1个疗程,比较两组治疗前后胎儿生长情况、生物物理评分和脐血流变化情况,以及比较两组新生儿出生时体重及围产儿并发症发生情况。结果:①治疗组宫高、胎儿双顶径、股骨长、头围及腹围的增长均明显高于对照组(P<0.05);②治疗组胎儿生物物理评分明显高于对照组,两者差异有显著性(P<0.05)。治疗组脐动脉收缩期最大血流速度与舒张末期血流速度比值(S/D)、搏动指数(PI)、阻力指数(RI)明显低于对照组,差异有显著性(P<0.05);③治疗组新生儿体重明显高于对照组(P<0.05);④治疗组胎儿宫内窘迫、新生儿窒息等围产儿并发症明显少于对照组,两者差异有显著性(P<0.05);⑤比较两组治疗前后血小板(PLT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB),差异无显著性(P>0.05)。结论:低分子肝素可改善胎盘血流,促进胎儿生长,有效治疗胎儿生长受限,且对母体和胎儿均较安全。

The clinical trial of low-molecular heparin on fetal growth restriction

Objective:To determine the clinical effect of low-molecular heparin on fetal growth restriction(FGR).Methods:64 cases with FGR were divided into study group and control group.Each group included 32 cases.Low-molecular-weight dextran and heparin were used in study group.Low-molecular-weight dextran and danshen were used in control group.The period of treatment was 7 days.Compared the difference in fetal growth status,biophysical score and changes in umbilical artery flow between the two groups before and after the treatment.Compared the birth weight of neonates and perinatal complications in the two groups.Results:①Height of fundus of uterus,biparietal diameter of fetus,femur length,head circumference and abdominal circumference of fetus of the study group were obviously higher than those of the control group;②Biophysical score of the study group was obviously higher than that of the control group.The difference was statistically significant(P<0.05).Umbilical blood S/D,pulsatile index(PI)and resistance index(RI)of the study group were significantly lower than those of the control group.The difference was statistically significant(P<0.05);③Birth weight of neonates of the study group was obviously more than that of the control group;④The complications,such as fetal distress and neonatal asphyxia,of the study group were obviously less than those of the control group.The difference was statistically significant(P<0.05);⑤No difference was shown in PLT,PT,APTT and FIB.The difference was not statistically significant(P>0.05).Conclusion:Low-molecular heparin can improve placenta function,promote fetal growth,have good effect on FGR.It is safe for both pregnant women and their fetuses.