低分子肝素治疗胎儿生长受限的临床疗效分析

目的 分析低分子肝素治疗胎儿生长受限的临床疗效。方法 选取2012年1月~2018年12月我院收治的60例胎儿生长受限（FGR）孕妇作为研究对象。根据治疗方案不同，分为对照组和实验组，各30例。对照组采用复方氨基酸及低分子右旋糖酐等治疗，实验组在对照组治疗的基础上给予低分子肝素，比较两组治疗前后孕周、胎儿生长指标、脐血流指标、羊水指标，实验组治疗前后D-D二聚体、血小板（PLT）、部分凝血活酶时间（APTT）、凝血酶原时间（PT）。结果 两组在治疗前后孕周差值比较，差异无统计学意义（P＞0.05）；两组胎儿生长指标、S/D比值、羊水指数、羊水最大前后径比较，差异无统计学意义（P＞0.05）；实验组治疗后APTT时间延长，与治疗前比较，差异有统计学意义（P＜0.05），D-D二聚体、PLT、PT与治疗前比较，差异无统计学意义（P＞0.05）。结论 低分子肝素对胎儿生长受限与传统治疗相比并没有明显优势，临床使用尚存在争议。

Clinical Analysis of Low Molecular Weight Heparin in the Treatment of Fetal Growth Restriction

Abstract:Objective To analyze the clinical efficacy of low molecular weight heparin in the treatment of fetal growth restriction.Methods 60 pregnant women with fetal growth restriction (FGR) admitted to our hospital from January 2012 to December 2018 were selected as subjects. According to different treatment options, they were divided into control group and experimental group, 30 cases each. The control group was treated with compound amino acid and low molecular weight dextran. The experimental group was given low molecular weight heparin on the basis of the control group. The gestational weeks before and after treatment, fetal growth index, umbilical blood flow index and amniotic fluid index were compared before and after treatment. DD dimer, platelet (PLT), partial thromboplastin time (APTT), prothrombin time (PT).Results There was no significant difference in gestational age difference between the two groups before and after treatment (P>0.05),there were no significant differences in fetal growth index, S/D ratio, amniotic fluid index, and amniotic fluid maximum anteroposterior diameter between the two groups (P>0.05). The APTT time in the experimental group was prolonged. Compared with before treatment, the difference was statistically significant (P<0.05). There was no significant difference between D-D dimer, PLT and PT before treatment (P>0.05).Conclusion Low molecular weight heparin has no obvious advantages compared with traditional treatment for fetal growth restriction. The clinical use is still controversial.