高压氧综合治疗对重度子癎前期合并胎儿生长受限患者的疗效分析  

The analysis of treatment effects of combination therapy with hyperbaric oxygen on fetal growth restriction induced by severe preeclampsia

作　　者：刘宏健[1] 吴小华 孙金豹[1] 苏海涛 王吉云[1] 魏振杰[1] 季景环[1] 

机构地区：[1]河北沧州市人民医院产科,河北沧州061000 [2]河北医科大学第四附属医院妇产科,河北石家庄050011 [3]河北省沧州市人民医院,河北沧州061000

出　　处：《中国实用妇科与产科杂志》2007年第2期113-116,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：河北省科技攻关计划(052761930)

摘　　要：目的探讨在综合改善胎盘微循环的基础上,应用高压氧纠正重度子癎前期合并胎儿生长受限(FGR)的疗效,及患者对高压氧治疗的适应性。方法2004-03-2006-02河北沧州市人民医院将符合筛选指标的住院重度子癎前期合并FGR的孕妇60例按自愿原则分为高压氧治疗组32例(A组)及非高压氧治疗组28例(B组),另外选择同期孕检正常妇女30例作为正常妊娠对照组(C组),比较胎儿生长指标、脐动脉血流,血流变及新生儿结局等指标,监测高压氧仓内各时段孕妇血压变化。结果高压氧综合治疗能显著降低胎儿脐动脉阻力指数(RI值)、脐动脉血流速率在收缩期末和舒张期末的比值(S/D值)及全血黏度低切值(LBV)(P<0.01);A组与B组相比能明显促进胎儿生长,延长孕周,增加新生儿体重,改善母婴预后,提高重度子癎前期合并FGR患者治疗的有效率(P<0.01)。结论高压氧结合常规治疗重度子癎前期合并FGR患者,可获得较好临床效果;重度子癎前期合并FGR的患者对高压氧治疗有较好适应性,母婴预后良好,值得临床推广。Objective To explore the treatment effects of hyperbaric oxygen （HBO） combined with routine methods for fetal growth restricton （FGR） caused by severe preeclampsia through improving the placental microcirculation, and analyze the adaptability of patients with severe preeclampsia to HBO. Methods Sixty patients with FGR induced by severe preeclampsia were voluntarily assigned to two groups ： group A, HBO group （ n = 32 ） , treated by HBO combined with routine methods; group B （ n = 28 ）, only receiving the routine therapy. In addition, thirty normal pregnant women served as normal control （ group C, n = 30）. Ultra-sound, umbilical artery blood flow velocity, hemorheology, and blood pressure of pregnant women in the treatment period were recorded periodically. Neonatal outcomes were also assessed among three groups in The people＇ s Hospital of Cangzhou, Hebei From March 2004 to March 2006. Results The values of RI, S/D and LBV （the blood viscosity at the low shear rate） in group A decreased significantly compared with those in group B （P 〈 0.01 ）. The average birth weight of neonates, the pregnant period and the effect rate of treatment in group A were significantly higher than those in group B （ P 〈 0.01 ）. Conclusion The valuable effects could be observed by means of HBO binding routine treatment in FGR induced by severe preeclampsia. Pregnant women with severe preeclampsia adapt well to HBO.

关 键 词：高压氧 重度子痈前期 胎儿生长受限 脐动脉 血流速度 血流变 超声 

分 类 号：R71[医药卫生—妇产科学]