低分子肝素联合常规治疗对孕晚期羊水过少孕妇的临床效果

Effect of low molecular weight heparin combined with conventional therapy on oligohydramnios in late pregnancy

目的观察低分子肝素联合常规治疗对孕晚期羊水过少孕妇的临床效果。方法抽取2018年2月至2020年11月南阳市第一人民医院收治的孕晚期羊水过少孕妇86例,按随机数字表法分为试验组与对照组,每组43例。对照组采用常规治疗,试验组在对照组基础上加用低分子肝素治疗。比较两组疗效、新生儿结局(头围、体质量、Apgar评分)和治疗前后羊水指标[最大羊水池深度(AFD)、羊水指数(AFI)]、血液参数[搏动指数(PI)、阻力参数(RI)]及凝血功能[活化部分凝血活酶(APTT)、凝血酶时间(PT)]。结果试验组总有效率(97.67%,42/43)高于对照组(81.40%,35/43),P<0.05。治疗后,两组AFD、AFI均较治疗前增高,且试验组高于对照组(P<0.05)。治疗后,两组PI、RI、S/D均较治疗前降低,且试验组低于对照组(P<0.05)。治疗后,两组APTT、PT较治疗前均无明显变化,且两组间比较差异未见统计学意义(P>0.05)。试验组新生儿头围、体质量、Apgar评分均高于对照组(P均<0.05)。结论低分子肝素联合常规治疗孕晚期羊水过少孕妇效果显著,可改善羊水情况和血液参数,且不会对凝血功能产生较大影响,可改善新生儿结局,提高新生儿身体状况。

Objective To analyze the effects of low molecular weight heparin combined with conventional therapy on oligohydramnios in late pregnancy.Methods A total of 86 pregnant women with oligohydramnios in late pregnancy treated in Nanyang First People’s Hospital from February 2018 to November 2020 were selected and divided into experimental group(n=43)and control group(n=43)according to random number table method.The control group received conventional treatment,and the experimental group received low molecular weight heparin based on the treatment of the control group.The curative effect,neonatal outcome including head circumference,body mass,Apgar score,amniotic fluid index including amniotic fluid depth(AFD)and amniotic fluid index(AFI),blood parameters including pulse(PI)and resistance index(RI),and coagulation function,assessed by activated partial thromboplastin time(APTT)and prothrombin time(PT),before and after treatment were compared between the two groups.Results The total effective rate of experimental group(97.67%,42/43)was higher than that of control group(81.40%,35/43),P<0.05.After treatment,the AFD and AFI in both groups were higher than before treatment,and those in experimental group were higher than those in control group(P<0.05).After treatment,the PI,RI,S/D in both groups were lower than before treatment,and these indexes in the experimental group were lower than those in the control group(P<0.05).After treatment,the APTT and PT in the two groups had no significant changes compared with before treatment,and there was no significant difference between the two groups(P>0.05).The head circumference,body weight and Apgar score in experimental groups were higher than those in control group(P<0.05).Conclusions Low molecular weight heparin combined with routine treatment has a significant effect on the late trimester oligohydramnios pregnant women.It can improve the amniotic fluid and blood parameters,without significant impact on the coagulation function,and can improve the neonatal outcome and physical condition of neonates.