低分子肝素钙围生期分级治疗对产后LDVT的防治效果观察

Observation on the Therapeutic Effect of Low Molecular Weight Heparin Calcium Perinatal Graded Treatment on Postpartum LDVT

目的:观察低分子肝素钙(LMWH)围生期分级治疗对产后下肢深静脉血栓(LDVT)的防治效果。方法:回顾性选取三明市第一医院2020年1月至2022年1月期间建档产检并分娩的产妇资料,根据深静脉血栓预防方案选取常规方案的884例产妇纳入对照组,选取884例应用围生期分级治疗的产妇纳入观察组。比较两组产妇产前、产后的凝血功能指标、下肢静脉血流速度的变化,统计两组产妇产后LDVT发生率及抗血栓治疗的不良反应发生率。结果:产后两组产妇凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均短于产前,D-二聚体(D-D)、血小板计数(PLT)均高于产前,且产后观察组产妇PT、APTT均长于对照组,D-D、PLT均低于对照组,差异具有统计学意义(P<0.05)。产后两组产妇各静脉血流速均快于产前,且观察组产妇各静脉血流速均快于对照组,差异具有统计学意义(P<0.05)。观察组产妇LDVT与不良反应发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:LMWH围生期分级治疗可降低产后LDVT发生率,且治疗方案安全可行。

Objective To observe the therapeutic effect of low molecular weight heparin calcium(LMWH)graded perinatal treatment on postpartum lower deep venous thrombosis(LDVT).Methods The data of pregnant women who had been registered and delivered in Sanming First Hospital from January 2020 to January 2022 were retrospectively selected.According to the prevention program of deep vein thrombosis,884 pregnant women with routine program were selected as the control group,and 884pregnant women with perinatal grading treatment were selected as the observation group.The changes of blood coagulation function indexes and lower limb venous blood flow velocity before and after delivery were compared between the two groups.The incidence of postpartum LDVT and the incidence of adverse reactions of antithrombotic therapy in the two groups were counted.Results After delivery,the prothrombin time(PT)and activated partial thromboplastin time(APTT)of the two groups were shorter than those before delivery,D-dimer(D-D)and platelet count(PLT)were higher than those before delivery,and the PT and APTT of the observation group were longer than those of the control group,and the D-D and PLT were lower than those of the control group,the differences were statistically significant(P<0.05).The venous blood flow velocity of postpartum women in the two groups was faster than that before delivery,and the venous blood flow velocity of the observation group was faster than that of the control group,and the difference was statistically significant(P<0.05).The LDVT and the incidence of adverse reactions in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion LMWH can reduce the incidence of postpartum LDVT,and the treatment plan is safe and feasible.