序贯用药预防妇科癌症术后深静脉血栓的疗效分析

The Efficacy Analysis of Sequential Application of LMWH and Enteric ASP in Preventing Postoperative DTV after Gynecologic Malignancy Surgery

目的探讨低分子肝素（LMWH）与肠溶阿司匹林（ASP）序贯应用预防妇科恶性肿瘤术后深静脉血栓（DVT）形成的疗效.方法选择2003年1月－2011年12月我院妇科恶性肿瘤大型手术652例,其中对照组共221例单独应用肠溶阿司匹林（ASP）,试验组共431例序贯应用低分子肝素（LMWH）与肠溶ASP,以D-二聚体测定、临床表现和彩超（CDFI）检查结果,统计学分析比较不同的用药方法预防术后DVT形成的效果.结果对照组确诊有症状型DVT11例,发病率4.98%;试验组确诊有症状型DVT6例,发病率1.39%,两组间差异有极显著意义（P〈0.01）.两组病例均无术后出血等用药并发症.结论 LMWH与肠溶ASP序贯应用预防妇科恶性肿瘤术后DVT效果满意,安全方便,并发症少,值得临床推广应用.

Objective To investigate the efficacy of the sequential application of low molecular weight hepa-rin（LMWH） and enteric-coated aspirin（ASP） in preventing postoperative deep venous thrombosis （DVT） after gyneco-logic malignancy surgery.Methods Six hundred and fifty-two cases who received major gynecological surgery of malig-nancies from January 2003 to December 2011 in the author＇s hospital were chosen.The control group with a total number of 221 cases used enteric-coated aspirin alone and the experimental group with a total number of 431 cases were sequen-tially applied with both the LMWH and the enteric-coated ASP.Through the examination of D-Dimer,the clinical mani-festations and color doppler flow imaging （CDFI）,the final results of the effect to prevent postoperative DVT were statisti-cally compared.Results It was found that there were 11 cases who were diagnosed of the symptoms of DVT in the con-trol group and the incidence rate was 4.98%,while the experimental group was confirmed with only 6 DVT cases and the incidence rate was merely 1.39%.It can be seen that the difference between the two groups was very significant （P〈0. 01）.There was no postoperative bleeding medication complications of either group .Conclusion The sequential applica-tion of LMWH and enteric ASP in preventing postoperative DVT after gynecologic malignancy surgeries has satisfactory results with safety,convenience and fewer complications ,which was worthy of clinical application .