低分子肝素联合硫酸镁对胎儿生长受限的效果及血流参数、母婴结局的影响

Effects of Low Molecular Weight Heparin Combined with Magnesium Sulfate on Fetal Growth Restriction,Blood Flow Parameters,and Maternal and In⁃fant Outcomes

目的研究胎儿生长受限(fetal growth retardation,FGR)采取低分子肝素(low molecular weight heparin,LMWH)联合硫酸镁治疗的临床效果,及对血流参数、母婴结局的影响。方法选取2019年4月—2022年3月徐州医科大学附属医院医联体医院接诊的74例FGR的孕妇。以随机数表法分为两组,研究组采取LMWH联合硫酸镁治疗(n=37),对照组采取LMWH治疗(n=37)。对比两组治疗后平均每周产妇宫高增长及胎儿生长情况,治疗前后胎儿脐血流参数,母婴不良分娩结局发生率。结果研究组平均每周产妇宫高增长值(1.53±0.38)cm,胎儿头围增长值(1.46±0.24)cm、腹围增长值(2.54±0.39)cm、双顶径增长值(2.30±0.43)cm、股骨长增长值(2.27±0.57)cm均高于对照组,差异有统计学意义(t=4.217、5.856、4.804、6.034、5.361,P<0.05)。治疗前,两组RI、PI、S/D指标水平对比,差异无统计学意义(P>0.05);治疗后,研究组RI水平(0.40±0.08)、PI水平(0.83±0.19)、S/D水平(2.12±0.45)均低于对照组的(0.53±0.10)、(1.08±0.23)、(2.37±0.53),差异有统计学意义(t=6.175、5.097、2.187,P<0.05)。研究组母婴不良结局发生率5.41%低于对照组35.14%,差异有统计学意义(χ^(2)=10.118,P<0.05)。结论对FGR给予LMWH联合硫酸镁治疗,可有效促进胎儿生长,改善血流参数,进而降低母婴不良分娩结局,保障母婴安全,值得借鉴。

Objective To study the clinical effect of low molecular weight heparin(LMWH)combined with magnesium sulfate in the treatment of fetal growth restriction(FGR),and its effect on blood flow parameters and maternal and infant outcomes.Methods A total of 74 pregnant women with FGR admitted to Medical Union Hospital,Affiliated Hospital of Xuzhou Medical University from April 2019 to March 2022 were selected.The patients were divided into two groups by random number table method.The study groupwas treated with LMWH combined with magnesium sulfate(n=37),and the control group was treated with LMWH(n=37).The average weekly maternal uterine growth and fetal growth after treatment,fetal umbilical blood flow parameters before and after treatment,and the incidence of adverse maternal and infant delivery outcomes were compared between the two groups.Results The average weekly increase in maternal uterine height(1.53±0.38)cm,fetal head circumference(1.46±0.24)cm,abdominal circumference(2.54±0.39)cm,and biparietal diameter(2.30±0.43)cm,femoral length growth value(2.27±0.57)cm in the study group were higher than the control group,the difference was statistically significant(t=4.217,5.856,4.804,6.034,5.361,P<0.05).There was no statistically significant difference in the levels of RI,PI and S/D between the two groups before treatment(P>0.05);after treatment,the RI level(0.40±0.08),PI level(0.83±0.19)and S/D level(2.12±0.45)of the study groupwere all lower than those of the control group(0.53±0.10),(1.08±0.23),(2.37±0.53),the difference was statistically significant(t=6.175,5.097,2.187,P<0.05).The incidence of maternal and infant adverse outcomes in the study group was 5.41%lower than that in the control group(35.14%),and the difference was statistically significant(χ^(2)=10.118,P<0.05).Conclusion LMWH combined with magnesium sulfate treatment for FGR can effectively promote fetal growth and improve blood flow parameters,thereby reducing adverse maternal and infant delivery outcomes and ensuring maternal and infant safety,which is worthy of reference.