低分子肝素联合硫酸镁治疗胎儿生长受限的疗效观察  

THE CLINICAL EFFECT OF LOW MOLECULAR WEIGHT HEPARIN AND MAGNESIUM SULFATE ON FETAL GROWTH RESTRICTION

作　　者：李春华[1] 陈宏霞[1] 

机构地区：[1]广东中山市人民医院产科,中山528400

出　　处：《现代预防医学》2011年第11期2031-2033,共3页Modern Preventive Medicine

摘　　要：[目的]探讨应用低分子肝素(LMWH)联合硫酸镁治疗胎儿生长受限(FGR)的疗效及可行性。[方法]选择胎儿生长受限(FGR)患者80例,随机分成研究组35例和对照组45例。在常规治疗的基础上,对照组给予低分子右旋糖酐联合丹参治疗,研究组给予LMWH联合硫酸镁治疗。于治疗前后测量宫高和腹围,并行B超检查,监测胎儿生长情况及脐血流指标;同时监测各项凝血指标,随访两组新生儿情况。[结果]①治疗后,研究组宫高、腰围增长值及胎儿双顶径、股骨长、头围、腹围增长值均显著高于对照组(P﹤0.05);②研究组与对照组比较,脐动脉收缩期最大血流速度(S)与舒张末期血流速度(D)的比值(S/D比值)、搏动指数(PI)、阻力指数(RI)均明显降低,差异有统计学意义(P﹤0.05);③与对照组相比,研究组新生儿胎龄显著延长,出生体重明显增加,1 min Apgar评分≤7分例数和出现足月小样儿的比例亦明显降低,差异有统计学意义(P﹤0.05);④各组孕妇治疗前后各项凝血功能检测值比较,差异均无统计学意义(P﹥0.05)。[结论]LMWH联合硫酸镁治疗FGR具有显著的疗效,可改善胎盘血供及功能,促进胎儿生长,对母体和胎儿均较安全。[Objective]To study the clinical effect and safety of low molecular weight heparin（LMWH）and magnesium sulfate on fetal growth restriction（FGR）.[Methods]80 FGR patients were randomly divided into two groups and were named study group（35 cases）and control group（45 cases）respectively.The control group was treated with D-40 and Danshen,the study group was treated by LMWH and magnesium sulfate.The fetal growth index and the umbilical artery blood flow were detected by colored Doppler ultrasound before treatment and after treatment.The prognoses of newborns were closely followed up.[Results]① The increases of fundal height,abdominal circumference of fetus,biparietal diameter,femur length,head circumference and abdominal circumference of fetus in the study group were obviously higher than those of the control group（P﹤0.05）.② Comparing with the control group,the S/D ratio,the resistance index（RI）and the pulsatility index（PI）decreased significantly（P﹤0.05）.③ The fetal age of newborns,birth weight and body length of study group were obviously increased and the rate of one-minute Apgar scores of neonates ≤7 and the incidence of mature small infants decreased significantly（P﹤0.05）.④ Platelet count,APTT and PT were not significantly changed in two groups before and after treatment（P﹥0.05）.[Conclusion]Low molecular weight heparin and magnesium sulfate can have good effect on FGR,improve blood supply of placenta and accelerate the growth of fetus.Low molecular weight heparin and magnesium sulfate are safe for both mother and fetus.

关 键 词：胎儿生长受限 低分子肝素 硫酸镁 

分 类 号：R722.19[医药卫生—儿科]