低分子肝素联合静脉营养治疗对胎儿生长受限的临床疗效及对超声参数的影响

Clinical Efficacy of Low Molecular Weight Heparin Combined with Intravenous Nutrition in the Treatment of Fetal Growth Restriction and Its Effect on Ultrasound Parameters

摘要

目的 探究低分子肝素与静脉营养联合治疗对于胎儿生长受限的临床疗效及对超声参数的影响。方法 选取2020年12月至2024年12月在鹤壁市人民医院接受治疗并完成分娩的胎儿生长受限孕妇86例，其中观察组43例采用低分子肝素联合静脉营养治疗，对照组43例给予静脉营养治疗。比较治疗3周后及分娩后的母婴相关指标。结果 经过3周的治疗，2组胎儿的生长发育指标（头围、腹围、股骨长、双顶径）均有不同程度增长（P <0.05），且观察组胎儿的上述生长发育指标数值均大于对照组（P <0.05）。治疗3周后，2组的脐动脉血流参数数值较治疗前减小（P <0.05），且观察组的收缩期峰值流速与舒张末期流速比值、阻力指数、搏动指数小于对照组（P <0.05）。观察组的新生儿体重和胎盘重量重于对照组，Apgar评分高于对照组，产妇分娩周数长于对照组（P <0.05）。组间剖宫产率经比较，差异无统计学意义（P >0.05）。观察组的新生儿不良事件总发生率低于对照组（P <0.05）。结论 采用低分子肝素联合静脉营养治疗对胎儿生长受限的临床效果较好，可促进胎儿生长发育，改善超声参数，且有益于改善母婴结局。

Abstract

Objective To investigate the clinical efficacy of low molecular weight heparin (LMWH) combined with intravenous nutrition in the treatment of fetal growth restriction (FGR) and its effect on ultrasound parameters.Methods A total of 86 pregnant women with FGR who received treatment and delivered infants at Hebi People's Hospital from December 2020 to December 2024 were enrolled. Among them, 43 patients in the intervention group received LMWH combined with intravenous nutrition, while 43 patients in the control group received intravenous nutrition alone. Maternal and neonatal indicators were compared between the two groups after 3 weeks of treatment and after delivery. Results After 3 weeks of treatment, the fetal growth parameters (head circumference, abdominal circumference, femur length, and biparietal diameter) in both groups increased (P <0.05), and these growth parameters in the intervention group were significantly greater than those in the control group (P <0.05). After 3 weeks of treatment, the umbilical artery blood flow parameters in both groups decreased compared with before treatment (P <0.05), and systolic/diastolic velocity ratio (S/D ratio), resistance index, and pulsatility index in the intervention group were significantly lower than those in the control group (P <0.05). The intervention group showed significantly higher birth weight and heavier placental weight, higher Apgar scores, and longer gestational age at delivery than the control group (P <0.05). No statistically significant difference was observed in the cesarean section rate between the two groups (P >0.05). The overall incidence of neonatal adverse events in the intervention group was significantly lower than that in the control group (P <0.05). Conclusion LMWH combined with intravenous nutrition demonstrates favorable clinical efficacy in the treatment of FGR, promoting fetal growth and development, improving ultrasound parameters, and benefiting maternal and neonatal outcomes.

关键词

胎儿生长受限 / 低分子肝素 / 静脉营养治疗 / 脐动脉血流 / 生长发育

Key words

fetal growth restriction / low molecular weight heparin / intravenous nutrition / umbilical artery blood flow / growth and development

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