胎儿宫内生长受限采用低分子肝素治疗的临床效果分析
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摘要
目的探讨胎儿宫内生长受限采用低分子肝素治疗的临床效果。方法选取2016年2月至2017年6月期间本院收治的90例胎儿宫内生长受限患者作为研究对象,随机分为实验组与对照组,每组45例。对照组患者给予复方丹参注射液治疗,实验组患者给予低分子肝素治疗,比较两组胎儿宫内生长情况、脐动脉血流情况、胎儿生物物理评分、新生儿体重、胎龄以及新生儿不良结局发生情况。结果治疗后,实验组胎儿头围、腹围、宫高、股骨长及双顶径的增长明显高于对照组,差异具有统计学意义(P<0.05);治疗后,实验组S/D、PI及RI均明显低于治疗前与对照组,实验组胎儿生物物理评分明显高于治疗前与对照组,差异具有统计学意义(P<0.05);实验组新生儿体重、胎龄均明显高于对照组[(3.42±0.53)kgVS(2.71±0.38)kg、(38.33±2.46)周VS(37.28±2.53)周],差异具有统计学意义(P<0.05);实验组新生儿不良结局总发生率明显低于对照组(2.22%VS 17.78%),差异具有统计学意义(P<0.05)。结论采用低分子肝素治疗胎儿宫内生长可有效改善胎盘血液灌注,促进胎儿生长发育,同时减少新生儿不良结局的发生,值得推广。
Objective To investigate the clinical efficacy of low molecular weight heparin(LMWH) in treatment of fetal growth restriction. Methods 90 cases of fetal growth restriction in our hospital from February 2016 to June 2017 were randomly divided into experimental group and control group, with 45 cases in each group. Control group was given compound Danshen injection, while experimental group was treated with LMWH. The intrauterine growth of fetus, umbilical artery blood flow, biophysical profile scores(BPPs), neonatal weight, gestational age, neonatal adverse outcome were compared between the two groups. Results After treatment, the fetal head circumference,abdominal circumference, fundal height, femur length, biparietal diameter in experimental group were higher than those in control group(P<0.05); After treatment, the S/D, PI, RI in experimental group were lower than those before treatment and control group, while the BPPs of experimental group was higher than that before treatment and control group(P<0.05); The neonatal weight and gestational age in experimental group were higher than those in control group [(3.42±0.53)kg VS(2.71±0.38)kg,(38.33±2.46)week VS(37.28±2.53)week](P<0.05);The total incidence of neonatal adverse outcome in experimental group was lower than that in control group(2.22%VS 17.78%)(P<0.05). Conclusion LMWH in treatment of fetal growth restriction can effectively improve placental blood perfusion, promote fetal growth and development, reduce neonatal adverse outcome, which is worthy of promotion.
Objective To investigate the clinical efficacy of low molecular weight heparin(LMWH) in treatment of fetal growth restriction. Methods 90 cases of fetal growth restriction in our hospital from February 2016 to June 2017 were randomly divided into experimental group and control group, with 45 cases in each group. Control group was given compound Danshen injection, while experimental group was treated with LMWH. The intrauterine growth of fetus, umbilical artery blood flow, biophysical profile scores(BPPs), neonatal weight, gestational age, neonatal adverse outcome were compared between the two groups. Results After treatment, the fetal head circumference,abdominal circumference, fundal height, femur length, biparietal diameter in experimental group were higher than those in control group(P<0.05); After treatment, the S/D, PI, RI in experimental group were lower than those before treatment and control group, while the BPPs of experimental group was higher than that before treatment and control group(P<0.05); The neonatal weight and gestational age in experimental group were higher than those in control group [(3.42±0.53)kg VS(2.71±0.38)kg,(38.33±2.46)week VS(37.28±2.53)week](P<0.05);The total incidence of neonatal adverse outcome in experimental group was lower than that in control group(2.22%VS 17.78%)(P<0.05). Conclusion LMWH in treatment of fetal growth restriction can effectively improve placental blood perfusion, promote fetal growth and development, reduce neonatal adverse outcome, which is worthy of promotion.
引文
[1]马莉琼.复方氨基酸联合丹参注射液治疗胎儿生长受陎的疗敁观察[J].中国基层医药,2017,24(15):2264-2268.
[2]Su EJ.Role of the fetoplacental endothelium in fetal growth restriction with abnormal umbilical artery Doppler velocimetry.[J].Am J Obstet Gynecol,2015,213(4 Suppl):S123-S130.
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[4]仸国平,王保莲,毕昡燕,等.丹参注射液联合肝素治疗胎儿生长受陎的临床疗敁及对孕妇血洿变的影响[J].世界中医药,2017,12(5):1032-1036.
[5]郭义红,李晓彫,陈亮,等.小剂量低分子肝素联合兊疫球蛋白治疗难治性兇兆洿产合幵绒毛膜下血肿敁果评价[J].临床和实验医学杂志,2017,16(16):1623-1627.
[6]Chávez-García A,Vázquez-Martínez ER,Murcia C,et al.Phenotypic and molecular characterization of intrauterine fetal growth restriction in interspecies sheep pregnancy.[J].JAnim Sci,2015,93(10):4692-4701.
[7]程国梅,张琳瑛,陶贝贝.低分子肝素治疗胎儿生长受陎的Meta分析[J].中国妇幼保健,2015,30(27):4755-4758.
[8]Singh N,Varshney P,Tripathi R,et al.Safety and efficacy of low molecular weight heparin therapy during pregnancy:three year experience at a tertiary care center.[J].J Obstet Gynaecol India,2013,63(6):373-377.
[9]乔文俊.低分子肝素钠在胎儿生长受陎治疗中的应用研究[J].中国综合临床,2014,30(3):332-333.
[10]Ghidini A.Overview of low molecular weight heparin for preventative treatment of adverse obstetric outcomes related to abnormal placentation.[J].Prenat Diagn,2014,34(7):649-654.
[11]乔娟,张园,钟梅.低分子肝素在子痫前期和复収性洿产中的应用迚展[J].实用医学杂志,2013,29(12):1894-1896.
[12]Ferrazzi E,Muggiasca M,Gervasi MT.Low molecular weight heparin:does it represent a clinical opportunity for preventing preeclampisa associated with fetal growth restriction[J].J Matern Fetal Neonatal Med,2015,28(13):1525-1529.
[13]曾色,梁桂云.低分子肝素治疗子痫前期合幵胎儿生长受陎的临床研究[J].中国妇幼保健,2014,29(36):6162-6164.
[14]陈乃珍.低分子肝素治疗重度子痫前期合幵胎儿生长受陎的疗敁和安全性研究[J].中国妇幼保健,2014,29(33):5514-5516.
[15]汪萍,協腾飞.低分子肝素联合硫酸镁治疗胎儿生长受陎的临床敁果及可行性[J].中国妇幼保健,2017,32(17):4171-4173.
[2]Su EJ.Role of the fetoplacental endothelium in fetal growth restriction with abnormal umbilical artery Doppler velocimetry.[J].Am J Obstet Gynecol,2015,213(4 Suppl):S123-S130.
[3]乐杰.妇产科学[M].7版.北京:人民卫生出版社,2008,130.
[4]仸国平,王保莲,毕昡燕,等.丹参注射液联合肝素治疗胎儿生长受陎的临床疗敁及对孕妇血洿变的影响[J].世界中医药,2017,12(5):1032-1036.
[5]郭义红,李晓彫,陈亮,等.小剂量低分子肝素联合兊疫球蛋白治疗难治性兇兆洿产合幵绒毛膜下血肿敁果评价[J].临床和实验医学杂志,2017,16(16):1623-1627.
[6]Chávez-García A,Vázquez-Martínez ER,Murcia C,et al.Phenotypic and molecular characterization of intrauterine fetal growth restriction in interspecies sheep pregnancy.[J].JAnim Sci,2015,93(10):4692-4701.
[7]程国梅,张琳瑛,陶贝贝.低分子肝素治疗胎儿生长受陎的Meta分析[J].中国妇幼保健,2015,30(27):4755-4758.
[8]Singh N,Varshney P,Tripathi R,et al.Safety and efficacy of low molecular weight heparin therapy during pregnancy:three year experience at a tertiary care center.[J].J Obstet Gynaecol India,2013,63(6):373-377.
[9]乔文俊.低分子肝素钠在胎儿生长受陎治疗中的应用研究[J].中国综合临床,2014,30(3):332-333.
[10]Ghidini A.Overview of low molecular weight heparin for preventative treatment of adverse obstetric outcomes related to abnormal placentation.[J].Prenat Diagn,2014,34(7):649-654.
[11]乔娟,张园,钟梅.低分子肝素在子痫前期和复収性洿产中的应用迚展[J].实用医学杂志,2013,29(12):1894-1896.
[12]Ferrazzi E,Muggiasca M,Gervasi MT.Low molecular weight heparin:does it represent a clinical opportunity for preventing preeclampisa associated with fetal growth restriction[J].J Matern Fetal Neonatal Med,2015,28(13):1525-1529.
[13]曾色,梁桂云.低分子肝素治疗子痫前期合幵胎儿生长受陎的临床研究[J].中国妇幼保健,2014,29(36):6162-6164.
[14]陈乃珍.低分子肝素治疗重度子痫前期合幵胎儿生长受陎的疗敁和安全性研究[J].中国妇幼保健,2014,29(33):5514-5516.
[15]汪萍,協腾飞.低分子肝素联合硫酸镁治疗胎儿生长受陎的临床敁果及可行性[J].中国妇幼保健,2017,32(17):4171-4173.