低分子肝素钠联合大量饮水干预对羊水过少孕妇宫腔环境及母婴结局的影响  

Effects of Low Molecular Weight Heparin Sodium Combined with High Fluid Intake Intervention on the Uterine Environment and Maternal-Fetal Outcomes in Pregnant Women with Oligohydramnios

作　　者：余彩霞 程爱华 YU Caixia;CHENG Aihua(Department of Obstetrics and Gynecology,Shangcai County People's Hospital,Zhumadian Henan 463800,China)

机构地区：[1]上蔡县人民医院妇产科,河南驻马店463800

出　　处：《临床研究》2025年第3期57-60,共4页Clinical Research

摘　　要：目的探讨低分子肝素钠联合大量饮水对羊水过少孕妇宫腔环境和母婴结局的影响。方法采用随机数表法将上蔡县人民医院2022年1月至2024年10月收治的90例羊水过少孕妇随机分为研究组和对照组,各45例,研究组给予低分子肝素钠联合大量饮水治疗,对照组给予低分子肝素钠治疗。比较两组干预前后炎症因子水平、凝血功能指标、宫腔环境和围产期相关指标的差异,并在孕妇分娩后统计不良母婴结局的发生情况。结果干预后两组肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(FIB)、胎儿脉搏灌注指数(PI)、胎儿脐动脉血流收缩期最大血流速率/舒张末期血流速率(S/D)均较干预前降低,凝血酶原时间(PT)、凝血酶时间(TT)、羊水指数(AFI)较干预前升高,差异有统计学意义(P<0.05);两组TNF-α、IL-8、hs-CRP、PT、TT、FIB比较,差异无统计学意义(P>0.05);研究组PI、S/D低于对照组,AFI高于对照组,差异有统计学意义(P<0.05)。两组分娩方式占比比较,差异无统计学意义(P>0.05),研究组破膜时间长于对照组,研究组5 min Apgar评分为8~10分占比高于对照组,差异有统计学意义(P<0.05);研究组总不良母婴结局发生率为4.44%(2/45),对照组总不良母婴结局发生率为6.67%(3/45),两组比较,差异无统计学意义(P>0.05)。结论低分子肝素联合大量饮水能够显著改善羊水过少孕妇宫腔环境,降低孕妇体内炎症因子水平和胎膜早破风险,减少不良母婴结局的发生,且对孕妇的凝血功能产生的负面影响较小。Objective To explore the impact of low molecular weight heparin sodium combined with high fluid intake on the uterine environment and maternal-fetal outcomes in pregnant women with oligohydramnios.Methods Ninety pregnant women with oligohydramnios admitted to Shangcai County People's Hospital from January 2022 to October 2024 were randomly divided into a study group and a control group,with 45 cases each.The study group received treatment with low molecular weight heparin sodium combined with high fluid intake,while the control group received only low molecular weight heparin sodium.The differences in levels of inflammatory factors,coagulation function indicators,uterine environment,and perinatal-related indicators before and after the intervention were compared,and adverse maternal-fetal outcomes were statistically analyzed after delivery.Results After the intervention,tumor necrosis factor-alpha(TNF-α),interleukin-8(IL-8),high-sensitivity C-reactive protein(hs-CRP),fibrinogen(FIB),fetal pulse index(PI),and the ratio of maximum blood flow velocity during systole to enddiastolic blood flow velocity(S/D)were all significantly lower compared to pre-intervention levels,while prothrombin time(PT),thrombin time(TT),and amniotic fluid index(AFI)were significantly higher(P<0.05).There were no significant differences in TNF-α,IL-8,hs-CRP,PT,TT,and FIB between the two groups(P>0.05).However,the PI and S/D in the study group were lower than in the control group,and the AFI was higher in the study group,with statistical significance(P<0.05).There was no significant difference in delivery method proportions between the two groups(P>0.05),but the membrane rupture time in the study group was longer than that in the control group.The proportion of 5-minute Apgar scores of 8-10 in the study group was higher than in the control group,with statistical significance(P<0.05).The overall incidence of adverse maternal-fetal outcomes in the study group was 4.44%(2/45),compared to 6.67%(3/45)in the control group,with no significant dif

关 键 词：羊水过少 低分子肝素钠 口服补液 宫腔环境 母婴结局 

分 类 号：R714[医药卫生—妇产科学]