低分子肝素在腹股沟疝无张力修补术围手术期的安全性评估

The safety assessment of Low Molecular Weight Heparin around surgery in patients with tension-free inguinal hernia repair

目的：探讨低分子肝素在腹股沟疝无张力修补术围手术期使用的临床安全性。方法：回顾性分析2012年2月~2015年2月于我院收治的73例单侧的腹股沟斜疝患者的住院治疗资料,将其中因疾病需长期口服阿司匹林的23例患者作为实验1组,口服华法林的24例患者作为实验2组,其余不需服用任何抗凝药物的26例患者作为对照组。实验1组和2组均在术前1周给予低分子肝素替代之前所用抗凝药物,对照组不给予任何抗凝治疗。随访并对比三组手术时间、血肿、住院时间、疼痛评分以及复发状况等指标,评估低分子肝素的临床使用安全性。结果：三组患者的血肿有无以及直径大小、手术时间、术后24h VAS疼痛评分、术后住院时间等指标差异不具有统计学意义（P〉0.05）。结论：对长期使用抗凝药物治疗的腹股沟疝患者,在无张力修补术围手术期使用低分子肝素代替抗凝治疗的临床安全性显著,不增加出血风险,还能预防血栓形成,值得推广。

Objective：To discussion the clinical safety of LMWH around surgepy in patients with tension-free inguinal hernia repair. Methods：Analyze retrospectively the hospitalization data of inguinal hernia 73 cases patients of unilateral treated from Fehruary 2012 to February 2015 period in our hospital , regard 23 patients required long-term aspirin due to illness as the experimental group, oral 24 patients on warfarin as the experimental group 2, while the remaining 26 patients without taking any anticoagulant drugs as the control group.Giving LMWH to the experimental group 1 and group ：2 one week before surgery,while the control group did not give any anticoagulant therapy. Following and comparing three groups of patients with operation time, hematoma, hospital stay, pain scores and relapse status indicators to assess the clinical safety of the use of low molecular weight heparin.Resuhs：The presence or absence of hematoma and diameter size, operative time, 24 hours VAS pain scores, postoperative hospital stay of three groups of patients were not significant statistically（P〉0.05 ）.Conclusion：For long-term use of anticoagulant therapy in patients with inguinal hernia, clinical safety of low molecular weight heparin in the tension-free repair instead of anticoagulant therapy during the perioperative is significant, does not increase the risk of bleeding, and can prevent the thrombosis, should he widely applied.