低分子肝素对双胎之一S/D值增高双胎妊娠结局及胎儿体格发育的影响  

EFFECTS OF OXYGEN INHALATION AND LOW MOLECULAR WEIGHT HEPARIN ON THE PREGNANCY OUTCOME AND PHYSICAL DEVELOPMENT OF TWIN FETUSES WITH INCREASED S/D VALUE OF CORD BLOOD FLOW

作　　者：田亚凤 张利娜 TIAN Yafeng;ZHANG Lina(Department of Obstetrics,The Weinan Maternal and Child Health Hospital of Weinan,Weinan 714000,China)

机构地区：[1]陕西省渭南市妇幼保健院产科,714000

出　　处：《中国煤炭工业医学杂志》2021年第1期41-45,共5页Chinese Journal of Coal Industry Medicine

基　　金：陕西省社会发展科技攻关项目(编号:2018SF136)。

摘　　要：目的探究低分子肝素对双胎之一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)增高双胎妊娠结局及胎儿体格发育的影响。方法采用随机计算机序列分组法将2015年3月—2018年3月在渭南市妇幼保健院接受治疗并分娩的86例双胎妊娠孕妇分为观察组和对照组,入选者均存在双胎之一脐动脉血流S/D值≥3.00。对照组给予常规治疗和吸氧干预;观察组在对照组基础上加用低分子肝素注射液静脉滴注进行治疗。观察二组妊娠结局及新生儿结局;比较二组治疗前后脐动脉血流S/D值、血流阻力指数(RI)和脐动脉搏动指数(PI)及新生儿出生时、随访1年时头围、身高、体重发育情况。结果与对照组比较,治疗后观察组孕周延长增加,早产、两新生儿体重差≥20%发生率、新生儿死亡率、新生儿重症病房(NICU)入住率均明显降低,低体重儿、小于孕龄儿、Apgar<7分发生率均明显下降(均P<0.05);但二组胎死宫内、新生儿窒息和呼吸窘迫综合征发生率比较,差异均无统计学意义(均P>0.05)。治疗后观察组S/D异常胎儿脐动脉血流S/D、RI、PI值均明显低于对照组(均P<0.05)。观察组新生儿出生时、随访1年时的头围、身高、体重等体格发育指标均明显优于对照组(均P<0.05)。结论低分子肝素能够有效改善双胎之一脐血流S/D值增高胎儿的脐动脉血流,延长孕周,改善妊娠结局和新生儿结局,促进新生儿体格发育。Objective To compare the effects of oxygen and low molecular weight heparin on the maximum blood flow velocity and end-diastolic blood flow velocity ratio(S/D)of umbilical arteries in twins,and the effects of twin pregnancy outcomes and physical development at 1 year of age.Methods A total of eighty-six twin pregnant women who received treatment and gave birth in Weinan Maternal and Child Health Hospital were divided into observation group and control group by random computer sequence grouping method.And the one S/D value of the one fetus was≥3.00.The control group was given routine treatment and oxygen intervention.The observation group was treated with intravenous drip of low molecular weight heparin injection on the basis of the control group.Pregnancy outcome and neonatal outcome were observed in the two groups.The development of umbilical artery blood flow S/D,blood flow resistance index(RI),umbilical artery pulse index(PI),head circumference,height and weight at birth and 1 year of follow-up were compared between the two groups before and after treatment.Results Compared with the control group,in the observation group after treatment,prolongation of gestational week was increased,preterm birth,incidence of birth weight difference≥20%,neonatal mortality rate,NICU occupancy rate were significantly reduced,and incidence of low birth weight,infants less than gestational age,Apgar<7 score was significantly decreased(P<0.05).However,there was no significant difference in the incidence of intrauterine fetal death,neonatal asphyxia and respiratory distress syndrome between the two groups(P>0.05).After treatment,the S/D,RI and PI values of abnormal fetal umbilical artery blood flow in the observation group were significantly lower than those in the control group(P<0.05).The physical development indexes such as head circumference,height and weight of newborns in the observation group at birth and 1 year of follow-up were significantly better than those in thecontrol group(P<0.05).Conclusion LMWH can effectively i

关 键 词：双胎妊娠 脐动脉 S/D增高 低分子肝素 妊娠结局 体格发育 

分 类 号：R714.1[医药卫生—妇产科学]