微量低分子肝素钙在严重创伤非显性DIC的临床研究

Clinical Study on Microdosage Low Molecular Weight Heparin in Severe Trauma Patients with Prophase State of Disseminated Intravascular Coagulation

目的：评价微量低分子肝素钙治疗严重创伤非显性DIC的疗效.方法：将44例严重创伤非显性DIC患者随机分为两组, 治疗组和对照组各22例.两组均采用综合治疗,治疗组早期加用低分子肝素钙,24 h用药量0.2～ 0.3 mg/（k g·d）,连用3 d.比较两组伤口渗血发生率、DIC发生率及病死率,观察治疗组应用微量肝素前后BPC、PT、APTT变化情况.结果：与对照组比较,治疗组DIC发生率、病死率明显降低（P均＜0.01）,伤口渗血发生率减少（P＜0.05）;治疗组应用微量肝素后,BPC升高（P＜0.05）,APTT、PT差异无显著性（P＞0.05）.结论：应用低分子肝素钙能有效地防止严重创伤非显性DIC向DIC的发展,并能降低病死率.

Objective： To investigate the therapeutic effect of microdosage low molecular weight heparin （LMWH） therapy in Severe Trauma patients with disseminated intravascular coagulation prophase state（pro-DIC）. Methods： Forty-four severe trauma patients in disseminated intravascular coagulation prophase state were randomly divided into routine treatment group （n=22,given microdosage LMWH , twice a day for 3 days, besides routine treatment） and control group （n 22,routine treatment）. The incidence of DIC and mortality in two groups were observed and compared. Results： Incidence of DIC and mortality in treatment group were significant lower than those in control group （P〈0.01）. Conclusion： Microdosage LMWH is applied early in severe trauma patients in disseminated intravascular coagulation prophase state, which could not only prevent efficiently DIC, but also diminish mortality.