低分子肝素钙预防腹腔镜术后下肢深静脉血栓形成的作用

The clinical value analysis of the use of single-use low-molecular-weight heparin before laparoscopic surgery in preventing deep venous thrombosis

目的探讨术前单次使用低分子肝素钙预防腹腔镜术后下肢深静脉血栓形成(DVT)的作用。方法使用前瞻性随机对照方法,将腹腔镜手术患者随机分成2组,研究组(A组)术前0.5 h皮下注射5 000μg低分子肝素钙,再行手术。对照组(B组)行常规腔镜手术。对比2组的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时间等。结果 A组的血栓率为0.5%,B组的血栓率为6.0%,比较差异有统计学意义(P<0.05)。2组在术中出血量、凝血四项及血小板计数变化、住院时间等均无差异(P>0.1)。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 The aim of this study is to investigate whether single - use Low - molecular - weight heparin before laparoscopic surgery is beneficial in preventing deep venous thrombosis （DVT）for clinical work. Methods A prospective, randomized study design was used, A Group：5 000 ug Low -molecularweight heparin injection 30 minutes before surgery. B Group：Generalc surgery. We investisate the the risk of DVT, the fluctuation of coagulation function, and blood platelet, the hospitalization time, and the postoperative intercurrent disease which is relevant to the single - use Low - molecular - weight heparin. Results Group 2 mean blood loss ,hospitalization time ,the fluctuation of 4 coagulation items,and blood platelet,there was no significant difference;Two groups of patients with follow -up, A group for DVT rate was 0.5%, B group the DVT rate was 6.0% ,there has significant difference （P 〈 0.05 ）. The postoperative intercurrent disease of A group were anaphylactoid cutireaction mostly, as none of the bleeding syndrome. Conclusion Before LC using a single Low -molecular -weight heparin in preventing DVT significant effect, On the surgery had little effect on post -operative bleeding. It is beneficial in clinical work safely and expediently.