目的 探討丹參注射液聯(lián)合硫酸鎂治療胎兒生長(zhǎng)受限的臨床療效。方法 選取2016年5月—2019年6月寶雞市婦幼保健院84例胎兒生長(zhǎng)受限孕婦為研究對(duì)象，根據(jù)就診單雙號(hào)將患者分為對(duì)照組（42例）和觀察組（42例）。對(duì)照組患者靜脈滴注丹參注射液聯(lián)合低分子右旋糖酐氨基酸注射液治療，將20 mL丹參注射液加入到10%葡萄糖溶液500 mL中靜脈滴注，30~40滴/min，1次/d；低分子右旋糖酐氨基酸注射液500 mL/d靜脈滴注。觀察組患者靜脈滴注丹參注射液聯(lián)合硫酸鎂注射液治療，將30 mL硫酸鎂注射液加入到5%葡萄糖溶液500 mL中靜脈滴注，1~2 g/h，1次/d；丹參注射液用法同對(duì)照組，兩組均持續(xù)用藥1周，之后間隔3~5 d再持續(xù)用藥1周，總用藥周期為3周。觀察兩組患兒的臨床療效、胎兒生長(zhǎng)及新生兒發(fā)育情況，同時(shí)比較兩組治療前后的血液流變學(xué)指標(biāo)。結(jié)果 治療后，觀察組患者總有效率為92.86%，顯著高于對(duì)照組的76.19%，兩組總有效率比較存在統(tǒng)計(jì)學(xué)差異（P<0.05）。治療后，觀察組胎兒頭圍、腹圍、股骨長(zhǎng)度、雙頂徑的增長(zhǎng)值均顯著高于對(duì)照組（P<0.05）。治療后兩組全血低切黏度、血漿黏度及紅細(xì)胞壓積均顯著降低（P<0.05）；且觀察組各血流變指標(biāo)水平均顯著低于對(duì)照組（P<0.05）。治療后，兩組患者D-二聚體（D-D）、纖維蛋白原（FIB）水平均顯著降低，凝血酶原時(shí)間（PT）和活化部分凝血酶原時(shí)間（APTT）均顯著升高（P<0.05），且觀察組各凝血功能指標(biāo)均明顯優(yōu)于對(duì)照組（P<0.05）。觀察組新生兒娩出胎齡、出生體質(zhì)量、身長(zhǎng)及1 min Apgar評(píng)分均顯著優(yōu)于對(duì)照組（P<0.05）。結(jié)論 丹參注射液聯(lián)合硫酸鎂可有效改善患者血流變指標(biāo)指標(biāo)，促進(jìn)胎兒生長(zhǎng)發(fā)育，療效顯著，值得臨床進(jìn)行應(yīng)用推廣。

Objective To investigate the clinical effect of Danshen Injection combined with magnesium sulfate in treatment of fetal growth restriction. Methods A total of 84 pregnant women with fetal growth restriction from May 2016 to June 2019 in Baoji Maternal and Child Health Care Hospital were selected as the study subjects, and the patients were divided into control group (42 cases) and observation group (42 cases) according to the odd-even number of visits. Patients in the control group were treated with intravenous drip of Danshen Injection combined with Dextran 40 and Amino Acid Injection, 20 mL Danshen injection was added to 500 mL 10% glucose solution for 30-40 drops/min, once daily, and Dextran 40 and Amino Acid Injection was 500 mL/d. Patients in the observation group were treated with intravenous infusion of Danshen Injection combined with Magnesium Sulfate Injection. 30 mL of Magnesium Sulfate Injection was added to 500 mL 5% glucose solution for intravenous infusion, 1-2 g/h, once daily. The usage of Danshen Injection was the same as that of the control group. Both groups were given continuous medication for one week, and the interval between 3-5 d was given continuous medication for one week, with a total medication cycle of three weeks. After treatment, the clinical efficacy, fetal growth and neonatal development in two groups were observed, and the hemorheology indexes before and after treatment were compared. Results After treatment, the total effective rate of the observation group was 92.86%, which was significantly higher than 76.19% of the control group, and the total effective rate between two groups was statistically different (P<0.05). After treatment, The growth values of fetal head circumference, abdominal circumference, femoral length, double parietal diameter in the observation group were significantly higher than those in the control group (P<0.05). After treatment, the whole blood viscosity, plasma viscosity, and hematocrit were significantly decreased in two groups (P<0.05), and the levels of hemorheology indexes in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of D-D and FIB in two groups were significantly decreased, PT and APTT were significantly increased (P<0.05), and the coagulation function indexes in the observation group were significantly better than those in the control group (P<0.05). Neonatal delivery age, birth weight, body length and 1 min Apgar score of newborn in the observation group were significantly better than the control group (P<0.05). Conclusion Danshen Injection combined with magnesium sulfate can effectively improve hemorheology indexes of patients and promote fetal growth and development, with significant curative effect, which is worthy of clinical application and promotion.

R984

中華國(guó)際科學(xué)交流基金會(huì)檢驗(yàn)檢測(cè)科技專(zhuān)項(xiàng)基金（Z2018LSXB007）