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目的观察低分子肝素钠联合低分子右旋糖酐和丹参注射液早期干预治疗胎儿生长受限的临床效果及对围生儿结局的影响。方法选取经产前检查诊断为胎儿生长受限的孕妇120例,分为观察组和对照组。在治疗母体基础性疾病基础上,观察组尽早进行2个疗程的治疗,低分子肝素钠深部皮下注射,每日1次,连用7d,低分子右旋糖酐加入丹参静脉滴注,1次/d,连用10d,10d为一疗程,疗程之间间隔7d,对照组单纯为加强饮食营养。每周观察孕妇宫高和腹围、胎儿双顶径、头围、股骨长。结果观察组孕妇每周测量的宫高和腹围、胎儿双顶径、头围、股骨长的增长明显大于对照组(P<0.05);观察组治疗后胎儿脐血流阻力指数下降,胎儿生物物理评分升高;观察组的孕周延长,剖宫产率,新生儿窒息率及围生儿死亡率均较对照组低(P<0.05)。结论胎儿生长受限是临床常见的高危妊娠,围生儿死亡率高。临床掌握正确的诊断方法,进行早期干预治疗,改善胎儿宫内生长环境,尽量延长孕周,对改善围生儿的结局至关重要。低分子肝素钠,低分子右旋糖酐和丹参注射液在改善胎盘循环,促进胎儿生长发育方面临床效果肯定。
Objective To observe the clinical effect of low molecular weight heparin combined with low molecular weight dextran and salvia miltiorrhiza injection on early fetal growth restriction and its effect on perinatal outcome. Methods A total of 120 pregnant women with fetal growth restriction diagnosed by prenatal examination were selected and divided into observation group and control group. On the basis of treatment of maternal basic diseases, the observation group treated with 2 courses as soon as possible. The mice were injected subcutaneously with low molecular weight heparin once daily for 7 days. The low molecular weight dextran was dosed intravenously with Salvia miltiorrhiza for 1 day, 10d, 10d for a course of treatment, the interval between treatment 7d, the control group simply to enhance diet and nutrition. Weekly observation of pregnant women Palace height and abdominal circumference, fetal biparietal diameter, head circumference, femur length. Results The growth rate of fetal height, abdominal circumference, biparietal diameter, head circumference and femur length in the observation group were significantly higher than those in the control group (P <0.05). In the observation group, the fetal cord blood flow resistance index decreased, Physical score increased; observation group gestational age prolonged, cesarean section rate, neonatal asphyxia and perinatal mortality were lower than the control group (P <0.05). Conclusion Fetal growth restriction is a common high-risk pregnancy, high perinatal mortality. Clinical master the correct diagnosis, early intervention, improve fetal growth environment, try to extend gestational age, to improve the outcome of perinatal children is essential. Low molecular weight heparin, low molecular weight dextran and Danshen injection in improving the placental circulation and promote fetal growth and development aspects of the clinical effect is affirmed.