低分子肝素钠治疗临界性羊水过少对产妇胎盘病理的影响  

The effect of low molecular weight heparin sodium on the pathology of placenta in pregnant women with critical oligohydramnios

作　　者：彭惠芬 康高杨 彭莹 姚业 侯斯琪 鲁云钢[1] PENG Huifen;KANG Gaoyang;PENG Ying;YAO Ye;HOU Siqi;LU Yungang(Department of Obstetrics,The First Hospital of Qiqihar,Qiqihar,Heilongjiang 161005,China)

机构地区：[1]齐齐哈尔市第一医院产科,黑龙江齐齐哈尔161005

出　　处：《中国优生与遗传杂志》2024年第5期1061-1065,共5页Chinese Journal of Birth Health & Heredity

基　　金：黑龙江省卫生健康委科研课题(20210505020010)。

摘　　要：目的对比研究低分子肝素钠治疗临界性羊水过少的临床效果,以及对产妇胎盘病理的影响。方法纳入了2020年1月至2022年12月在齐齐哈尔市第一医院产科接受治疗的临界性羊水过少孕妇80例作为研究对象,随机分为干预组和对照组。对照组孕妇每天静脉滴注林格氏液1000mL。干预组则在每天静脉滴注林格氏液1000mL基础上,给予低分子肝素钠5000单位皮内注射,1次/d。以连续用药治疗7 d为一个疗程。对比分析治疗前后产妇羊水指数(AFI)、脐动脉收缩期峰值和舒张末期流速之比(S/D)、胎盘病理和妊娠结局的影响。结果治疗前两组孕妇AFI和S/D值相比差异无统计学意义(P>0.05)。治疗后两组比较,干预组孕妇治疗后AFI数值要高于对照组,而S/D值则要低于对照组(P<0.05)。对照组检出胎盘病变38例(95.0%),干预组检出胎盘病变21例(52.5%)。经过治疗后,干预组剖宫产、早产、新生儿Apgar评分≤7分发生率均要低于对照组(P<0.05);而宫内窘迫、产后大出血发生率和新生儿低体质量发生率这3个指标方面两组之间比较差异无统计学意义(P>0.05)。干预组经低分子肝素钠治疗后,血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原含量(FIB)指标与治疗前相比差异无统计学意义(P>0.05)。结论低分子肝素钠可以更有效地增加临界羊水过少孕妇的羊水量,降低脐动脉血流阻力,改善胎盘血流灌注和胎盘病理损伤,进而改善临界羊水过少孕妇的妊娠结局。Objective Comparative study on the clinical efficacy of low molecular weight heparin sodium in the treatment of critical oligohydramnios and its impact on placental pathology in parturients.Methods 80 borderline oligohydramnios pregnant women who received treatment in the Department of Obstetrics of the First Hospital of Qiqihar from January 2020 to December 2022 were included as the study subjects and randomly divided into an intervention group and a control group.The control group of pregnant women received 1000 mL of Ringer's solution intravenously every day.The intervention group received 5000 units of low molecular weight heparin sodium subcutaneous injection once a day,based on a daily intravenous infusion of 1000 mL of Ringer's solution.Continuous medication treatment for 7 days is a course of treatment.Compare and analyze the effects of maternal amniotic fluid index(AFI),ratio of peak systolic to end diastolic flow velocity(S/D)of umbilical artery,placental pathology,and pregnancy outcomes before and after treatment.Results There was no statistically significant difference in AFI and S/D ratio between the two groups of pregnant women before treatment(P>0.05).After treatment,the AFI values of pregnant women in the intervention group were higher than those in the control group,while the S/D ratio was lower than that in the control group(P<0.05).Placental lesions were detected in 38 cases(95.0%)in the control group and 21 cases(52.5%)in the intervention group.After treatment,the incidence of cesarean section,premature delivery,and neonatal Apgar score≤7 in the intervention group was lower than that in the control group(P<0.05).There was no statistically significant difference between the two groups in terms of three indicators:intrauterine distress,incidence of postpartum hemorrhage,and incidence of low birth weight in newborns(P>0.05).After receiving low-molecular-weight heparin sodium,there was no statistically significant difference in PLT,PT,APTT,TT,and FIB indicators between the intervention group and

关 键 词：临界性羊水过少 低分子肝素钠 胎盘 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]