低分子肝素治疗人类辅助生殖技术获得妊娠后复发性流产的效果

Effect of Low Molecular Weight Heparin in the Treatment of Recurrent Miscarriage After Pregnancy in Human Assisted Reproductive Technology

目的 探讨人类辅助生殖技术获得妊娠后出现复发性流产征兆的患者使用低分子肝素进行治疗的效果。方法 选取莆田九十五医院2020年6月—2022年6月收治的68例使用人类辅助生殖技术获得妊娠后经保胎治疗的复发性流产患者为研究对象,随机将其分为2组,每组34例。对照组予以常规治疗,研究组予以常规治疗+低分子肝素治疗。比较2组治疗前后凝血功能指标、激素水平、妊娠结局以及不良反应发生情况。结果 治疗后,2组D-二聚体(D-dimer,D-D)、纤维蛋白原水平均低于治疗前,且研究组低于对照组(P <0.05)。治疗后,2组孕酮(progesterone,P)、人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)、雌二醇(estradiol,E2)水平均高于治疗前,且研究组高于对照组(P <0.05)。研究组足月生产率为70.59%,高于对照组的41.18%;研究组流产率为17.65%,低于对照组的44.12%(P <0.05);2组早产率比较,差异无统计学意义(P> 0.05)。2组不良反应总发生率比较,差异无统计学意义(P> 0.05)。结论 经过人类辅助生殖技术获得妊娠后出现复发性流产征兆的患者使用低分子肝素进行治疗可以改善患者激素水平及凝血功能指标,提高足月生产率,且不增加不良反应。

Objective To investigate the effect of low molecular weight heparin in the treatment of recurrent miscarriage after pregnancy in human assisted reproductive technology.Methods A total of 68 patients with recurrent abortion treated with fetal preservation after successful pregnancy using human assisted reproductive technology in Putian 95 Hospital from June 2020 to June 2022 were selected as the study objects,and randomly divided into 2 groups,with 34 patients in each group.The control group received conventional treatment,and the study group received conventional treatment+low molecular weight heparin treatment.Coagulation function indexes,hormone levels,pregnancy outcomes and adverse reactions were compared between the two groups before and after treatment.Results After treatment,D-dimer(D-D)and fibrin water in 2 groups were lower than before treatment,and the study group was lower than the control group(P<0.05).After treatment,progesterone(P),human chorionic gonadotropin(HCG),estradiol(E2)levels in 2 groups were higher than before treatment,and the study group was higher than the control group(P<0.05).The full-term productivity of the study group was 70.59%,higher than that of the control group(41.18%).The abortion rate in the study group was 17.65%,which was lower than 44.12%in the control group(P<0.05).There was no significant difference in the preterm birth rate between the study group and the control group(P>0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Treatment with low molecular weight heparin in patients with recurrent miscarriage after successful pregnancy through human assisted reproductive technology can improve the hormone levels and coagulation function indicators of patients,improve term productivity,and do not increase adverse reactions.