低分子肝素治疗重度子痫前期合并胎儿生长受限疗效观察

Clinical effects observation of low molecular weight heparin in treatment of severe preeclampsia combined with fetal growth restricted patients

目的探讨小剂量低分子肝素治疗重度子痫前期合并胎儿生长受限的临床疗效及安全性。方法选取2013年1月-2016年6月我科收治的重度子痫前期合并胎儿生长受限的孕妇74例为观察组,选择同期我科收治的重度子痫前期合并胎儿生长受限的孕妇77例为对照组,对照组予常规治疗,观察组在此基础上加用低分子肝素。比较两组胎儿双顶径、股骨长度、腹围、头围等生长数据,S/D比值、PI、RI等脐血流指标及期待治疗时间、新生儿出生体重、早产和新生儿重度窒息发生率。结果治疗前,两组胎儿双顶径、股骨长、头围和腹围每周增长,脐动脉S/D比值、PI及RI比较,差异无统计学意义（P〉0.05）,治疗后观察组胎儿双顶径、头围、股骨长和腹围每周增长均大于对照组,脐动脉S/D比值、PI及RI均低于对照组,差异有统计学意义（P〈0.05）;对照组期待治疗时间显著短于观察组,胎儿出生体重大于对照组,早产发生率低于对照组,差异均有统计学意义（P〈0.05）。结论小剂量低分子肝素治疗重度子痫前期合并胎儿生长受限可改善妊娠结局。

Objective To investigate the clinical effects and safety of low molecular weight heparin in treatment of severe preeclampsia combined with fetal growth restricted patients. Methods 74 patients of severe preeclampsia with fetal growth restricted patients cured in our department from January 2013 to June 2016 were selected as observation group.In addition,another 77 patients of severe preeclampsia with fetal growth restricted over the same period were selected as control group.Patients in control group were treated with conventional treatment,and patients in observation group were given low molecular weight heparin combined conventional treatment.The fetal biparietal diameter,femur length,abdominal girth,head circumference,S/D ratio,PI,RI,expectant management time,neonate birth weight,the recurrence of premature and newborn severe asphyxia were compared between two groups. Results Before treatment,there was no significant difference of fetal biparietal diameter,femur length,abdominal girth,head circumference,S/D ratio,PI and RI between two groups（P 〉 0.05）.After treatment,the increasing range of fetal biparietal diameter,femur length,abdominal girth and head circumference were larger than those of control group,and S/D ratio,PI and RI were lower than those of control group.The differences were statistically significant（P 〈 0.05）.In observation group,the expectant management time was longer than that of control group,the neonate birth weight was greater than that of control group,and the recurrence of premature was lower than that of control group.The differences were statistically significant（P 〈 0.05）. Conclusion Low molecular weight heparin has an obvious therapeutic effect in the treatment of severe preeclampsia with fetal growth restricted patients.