低分子肝素联合低分子右旋糖酐治疗羊水过少的研究.docVIP

低分子肝素联合低分子右旋糖酐治疗羊水过少的研究 72D doi:10.3969~.issn.0253-9896.2011.08.017 TianjinMedJ,Aug2011,Vol39No8 低分子肝素联合低分子右旋糖酐治疗羊水过少的研究 孟晓蓉周玮刘颖熊正爱 摘要目的:观察应用低分子肝素联合低分子右旋糖酐治疗羊水过少的临床效果及安全.I生.方法:73例羊水过 少孕妇随机分为3组,联合治疗组21例予以低分子肝素0.4mL皮下注射和5%低分子右旋糖酐500mL静脉滴注;低 分子肝素治疗组20例给予低分子肝素0.4mL皮下注射;对照组32例予以能量合剂(5%葡萄糖500mL,腺苷磷酸 40mg,肌酐0.4g,辅酶A100U)和10%复方氨基酸(18AA)250mL静脉滴注.比较各组治疗前后羊水指数(AFI)和相 关凝血指标变化.结果:经过1个疗程的治疗,联合治疗组,低分子肝素组的好转率均明显高于对照组,差异有统训’学 意义(Plt;0.05).联合治疗组AFI增加值优于低分子肝素组(Plt;0.05).治疗前后孕妇凝血相关指标比较,差异无统 计学意义(均Pgt;0.05),未发现治疗引起的凝血功能障碍.结论:低分子肝素联合低分子右旋糖酐是治疗妊娠期羊水 过少的有效方法,对孕妇均比较安全. 关键词羊水过少右旋糖酐肝素,低分子量血液凝固试验 ResearchontheEffectsofLowMolecularWeightHeparinCombinedwithDextran-40on Oligohydramnios MENGXiaorong,ZHOUWei,LIUYing,XIONGZheng’ai DepartmentofObstetricandGynecology,People’SHospitalofChangshou,Chongqing401220,China AbstractObjective:Toinvestigatetheeffectsandsafetyoflowmolecularweightheparin(LMWP)combinedwithdex— tran一40onpregnantwomenwitholigohydramnios.Methods:Atotalof73pregnantwomendiagnosedasoligohydramnios wererandomizedintocombinedtherapygroup(n=21),LMWPgroup(n=20)andcontrolgroup(n=32).Patientsofcombined therapygroupweretreatedwith0.4mLofLMWPand500mLof5%dextran-40.PatientsofLMPWgroupweretreatedwith 0.4mLofLMPWsubcutaneousinjectiononly.Patientsofcontrolgroupweregiven500mLof5%glucoseinfusedwith40mg ofadenosinetriphosphate,0.4gofcarnine,1O0UofcoenzymeAand250mLofcompoundaminoacids.Anmioticfluidjndex (AFI)andcoagulogrammarkerswerecomparedbeforeandaftertreatmentinthreegroups.Results:Theimprovementrates weresignificanthigherincombinedtherapygroup(90.5%)andLMWPgroup(80.0%)thanthatincontrolgroup(46.9%,Plt; 0.05).TheaverageincreasingvolumeofAF1wassignificantlyhigherincombinedtherapygroupthanthatofLMWPgroup 『尸lt;0.05).Therewasnosignificantdifferenceinbloodcoagulationindicationbeforeandaftertreatmentbetweeneach groupfPgt;O.05).Conclusion:LMWPcombinedwithdextran一40couldimprovevolumeofamnioticfluideffectivelyinpa— tientssufferedwitholigohydramnios,whichwassafeforboththemotherandtheunbornfetus. Keywordsolig0