依诺肝素与磺达肝癸钠在复发性流产患者再次妊娠抗凝治疗中的应用效果比较  

Effect of enoxaparin and fondaparinux in anticoagulant therapy for re-pregnant women with recurrent miscarriage

作　　者：刘红[1] 王爱香[1] 桑秀丽[1] Liu Hong;Wang Aixiang;Sang Xiuli(Department of Obstetrics and Gynecology,Third People’s Hospital of Anyang,Anyang 455000,China)

机构地区：[1]河南省安阳市第三人民医院妇产科,455000

出　　处：《中国实用医刊》2021年第16期106-109,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨复发性流产患者妊娠期抗凝治疗中应用依诺肝素与磺达肝癸钠的效果。方法抽取2016年6月至2020年6月安阳市第三人民医院收治的66例复发性流产再次妊娠且血液高凝状态患者进行研究,纳入对象均有完整临床资料,自愿配合研究且签署知情同意书。应用随机数字表法分为观察组与对照组,每组33例。对照组选择依诺肝素进行妊娠期抗凝治疗,观察组选择磺达肝癸钠治疗。比较两组妊娠结局与不良反应情况。结果两组活产率、胎儿生长受限(FGR)发生率、中期妊娠胎儿丢失率、子痫前期发生率、胎盘早剥率、再次发生早期妊娠自然流产率比较,P>0.05,但观察组新生儿体质指数大于对照组(P<0.05);观察组注射部位皮肤反应率、注射部位皮下瘀斑血肿率、转氨酶升高率低于对照组(P<0.05),但两组口鼻黏膜出血率、血小板降低率、产后出血率、活化部分凝血活酶时间(APTT)延长率比较,P>0.05。结论对于复发性流产再次妊娠且伴有血液高凝状态的患者,选择合适的妊娠期抗凝治疗十分关键,磺达肝癸钠相比依诺肝素可提高新生儿的体质指数,安全性好。Objective To investigate the effects of enoxaparin and fondaparinux in anticoagulant therapy for re-pregnant women with recurrent miscarriage.Methods A total of 66 re-pregnant women with recurrent miscarriage and hypercoagulable state who were admitted to Third People’s Hospital of Anyang from June 2016 to June 2020 were selected for research.All included subjects had complete clinical data,volunteered to cooperate with the study and signed informed consent.Using random number table method,they were divided into observation group and control group,with 33 patients in each group.Patients in the control group was treated with enoxaparin for anticoagulation therapy during pregnancy,and the observation group was treated with fondaparinux sodium therapy.The pregnancy outcomes and adverse reactions between the two groups were compared.Results The live birth rate,the incidence of fetal growth restriction(FGR),the fetal loss rate in the second trimester,preeclampsia rate,placental abruption rate and spontaneous abortion rate in the second trimester were compared between the two groups,P>0.05,but the weight of newborns in the observation group was greater than that of the control group(P<0.05);the skin reaction rate,subcutaneous ecchymosis hematoma rate and transaminase elevation rate of the observation group were lower than those of the control group(P<0.05),the bleeding rate of oral and nasal mucosa,the thrombocytopenia rate,postpartum hemorrhage rate and the prolongation rate of activated partial thromboplastin time(APTT)were compared between the two groups,P>0.05.Conclusions For patients with recurrent miscarriage and re-pregnancy with blood hypercoagulability,it is very important to choose the appropriate anticoagulant therapy in pregnancy,sulfonidagandecane sodium can improve the body mass index of newborn compared with enoxaparin,and the safety is good.

关 键 词：流产 复发性 再次妊娠 依诺肝素 磺达肝癸钠 

分 类 号：R714.21[医药卫生—妇产科学]