低分子肝素钙对腹腔镜胆囊切除术预防下肢深静脉血栓形成的临床价值分析

Effects of single-use of low-molecular-weight heparin before laparoscopic cholecystectomy for prevention of deep venous thrombosis

目的:研究术前单次使用低分子肝素钙对腹腔镜胆囊切除术(LC)下肢深静脉血栓形成(DVT)的临床应用价值。方法:使用前瞻性随机对照方法,将382例LC患者随机分成两组,研究组(A组,182例)术前半小时皮下注射5 000μg低分子肝素钙,再行LC。对照组(B组,200例)行常规LC手术。比较两组下肢深静脉血栓的发生率、凝血功能变化、术后相关并发症及住院天数等。结果:A组的血栓率为0.5%,B组6.0%;差异有统计学意义(P<0.05)。两组在术中出血量、凝血四项及血小板计数变化、住院时间差异无统计学意义(P>0.05)。A组术后肝素相关并发症多为皮肤过敏,无出血并发症。结论:腹腔镜胆囊切除术前使用单次低分子肝素钙对预防下肢深静脉血栓形成疗效明显,对术中术后出血无明显影响,安全、简便,具有一定临床应用价值。

Objective： To investigate effects of single-use of low-molecular-weight heparin before laparoscopic cholecystectomy（LC） for prevention of deep venous thrombosis（DVT）.Methods： In this prospective,randomized study,382 patients that scheduled for LC were assigned into group A（182 cases） and group B（200 cases）.GroupA were given subcutaneous injection of 5 000 μg low-molecular-weight heparin before surgery,while group B just underwent routine LC.Incidence of DVT,changes in coagulation function,and blood platelet counts,complications as well as length of hospital stay were compared between the two groups.Results： The incidence of DVT in group A and B was 0.5% and 6.0%,respectively,showing significant difference（P0.05）.No significant difference in blood loss volume,coagulation function,blood platelet counts,complications as well as length of hospital stay were observed between the two groups（P0.05）.Conclusions： Single-use of low-molecular-weight heparin before LC shows obvious effects on prevention of deep venous thrombosis（DVT） without inducing side effects and it′s safe,easy to be administrated and worth for application in large scale.