低分子肝素联合硫酸镁治疗胎儿生长受限效果及对围生儿结局影响

Effect of low molecular weight heparin combined with magnesium sulfate on fetal growth restriction

目的探讨低分子肝素联合硫酸镁对胎儿生长受限(FGR)的治疗效果及对围生儿预后的影响。方法选取自2019年6月至2021年7月在北部战区总医院进行FGR治疗的300例孕妇为研究对象。采用随机数字表法将其分为观察组与常规组,每组各150例。常规组皮下注射低分子肝素钠进行干预,观察组在常规组基础上静脉注射硫酸镁进行干预。比较治疗前后母体腹围差、胎儿生长状况相关指标,孕妇的羊水指数和胎儿生物物理评分,以及围生儿结局相关指标。结果观察组孕妇平均每周腹围增长值及胎儿生长状况相关指标均高于常规组,差异有统计学意义(P<0.05)。治疗后,观察组脐动脉血流S/D值低于常规组,孕妇的羊水指数及生物物理评分均高于常规组,差异均有统计学意义(P<0.05)。两组新生儿窒息率比较,差异无统计学意义(P>0.05)。观察组新生儿Apgar评分、新生儿体质量、新生儿胎龄均高于常规组,足月小样儿、早产儿发生率低于常规组,差异有统计学意义(P<0.05)。结论低分子肝素联合硫酸镁治疗FGR的效果显著,且安全性较高。

Objective To investigate the therapeutic effect of low molecular weight heparin combined with magnesium sulfate on fetal growth restriction(FGR)and the prognosis of perinatal infants.Methods A total of 300 pregnant women treated with FGR at the General Hospital of Northern Theater Command from June 2019 to July 2021 were selected as the study subjects.They were divided into observation group and routine group by random number table method,150 cases in each group.The routine group was subcutaneously injected with low molecular weight heparin sodium for intervention,and the observation group was intravenously injected with magnesium sulfate on the basis of the routine group for intervention.Maternal abdominal circumference,fetal growth status,amniotic fluid index and fetal biophysical score of pregnant women,and perinatal outcomes were compared before and after treatment.Results The average weekly growth of abdominal circumference and related indexes of fetal growth in the observation group were higher than those in the routine group,with statistical significance(P<0.05).After treatment,the umbilical artery blood flow S/D value in the observation group was lower than that in the routine group,and the amniotic fluid index and biophysical score of pregnant women were higher than those in the routine group,with statistical significance(P<0.05).There was no significant difference in neonatal asphyxia rate between the two groups(P>0.05).The Apgar score,body weight and gestational age of neonates in the observation group were higher than those in the routine group,and the incidence of full-term infants and premature infants was lower than that in the routine group,with statistical significance(P<0.05).Conclusion Low molecular weight heparin combined with magnesium sulfate in the treatment of FGR has a significant effect and high safety.