25%硫酸镁加低分子右旋糖酐对治疗胎儿生长受限的作用

The effect of Magnesium Sulfate and Low Molecular Weight Dextran on fetal growth restriction

目的探讨25%硫酸镁加低分子右旋糖酐对治疗胎儿生长受限的作用。方法将100例胎儿生长受限孕妇分为对照组与治疗组进行对比治疗效果。对照组:常规吸氧,休息,左侧卧位,补充钙锌微量元素,每天静脉滴注能量合剂:10%葡萄糖500ml+辅酶A100U+三磷酸腺苷40mg+维生素C2g,复方氨基酸250ml,连用10d为一疗程。治疗组:按上述常规治疗方法治疗5d后,静脉补液再加用25%硫酸镁40ml+5%葡糖糖500ml,低分子右旋酐糖500ml,1次/d,连用5d,此为一疗程。结果治疗组较对照组彩色多勒显示胎儿脐血流S/D比值明显降低,治疗组较对照组镁母血离子浓度比较差异有统计学意义,胎儿双顶径差异有统计学意义(P<0.05),治疗组新生儿体重明显高于对照组,胎盘重量明显重于对照组,差异有统计学意义,(P<0.01)。结论 25%硫酸镁加低分子右旋糖酐静脉滴注治疗胎儿宫内生长受限,能改善胎盘血流灌注,明显改善脐血流S/D值,改善血液黏度,恢复正常胎盘功能,增加对母体静脉输入葡萄糖、能量合剂、复方氨基酸摄取量,促进胎儿生长发育。本方法实用性强,明显优于传统治疗方法。

Objective To investigate the effect of Magnesium Sulfate and Low Molecular Weight Dextran on the fetal growth restriction （FGR）. Methods 100 cases with FGR were divided into control group and study group. Each group included 50 cases. Oxygen uptake, left lateral position, IVH intravenous hyperalimentation with Energy Mixture（ 10% Glucose 500 ml＋CoA 100U＋Triphosaden 40mg ＋Vitamin C 2 g） and Compound Amina Acidwere （250 ml）used in control group for 10 days. In study group, the treatment of control group received for 5 days,then Magnesium Sulfate（40 ml）,5%Glucose（500 ml）and Low Molecular Weight Dextran（500 ml）were used for 5 days,once a day.Compared the difference in fetal growth status and changes in umbilical artery flow between the two groups before and after the treatment.Compared the birth weight of neonates and perinatal complications in the two group.Results Height of fundus of uterus,biparietal diameter of fetus,femur length,head circumference and abdominal circumference of fetus of the study group were obviously higher than those of the control group.The difference was statistically significant（P0.05）.Umbilical blood S/D of the study group was significantly lower than the control group.The difference was statistically significant （P0.05）.The birth weight of neonates and the weight of the placenta of the study group were obviously more than those of the control group（P0.01）.Conclusion Magnesium Sulfate and Low Molecular Wight Dextran can improve placenta function,promote fetal growth,which has a obviously effect on FGR.It is safe for both pregnant women and their fetuses.