低分子肝素在剖宫产术后预防深静脉血栓形成中的应用

Application of low molecular weight heparin in preventing the deep venous thrombosis after caesarean section

目的探讨预防剖宫产术后深静脉血栓形成的有效方法。方法选择2010年8月至2012年8月就诊于阜阳市人民医院产科的285例具有发生深静脉血栓高危风险的剖宫产术后产妇,随机分为治疗组及对照组,治疗组140例,于剖宫产术后24 h皮下注射低分子肝素钙5000 IU,每日1次,连续5 d;对照组145例,不使用低分子肝素及其他任何抗凝药物;术前及术后第4天监测凝血功能。结果治疗组无一例发生深静脉血栓,对照组发生4例下肢深静脉血栓,无1例肺栓塞,两组深静脉血栓发生率比较差异有统计学意义(P<0.05);治疗组术后D-二聚体及纤维蛋白原变化与对照组差异有统计学意义(P<0.05),两组患者出血倾向比较差异无统计学意义(P>0.05)。结论低分子肝素在预防剖宫产术后深静脉血栓形成方面效果确切,且无明显出血风险,有特异临床应用价值。

Objective To investigate the effective preventive method for deep venous thrombosis after caesarean section.Methods Form August 2010 to August 2012,285 patients after caesarean section with high risk of deep venous thrombosis were randomly divided into two groups： 140 patients in treatment goup were treated with low molecular weight heparin 5000 IU,24 hours after surgery,once per day for five days.At the same time,145 patients in control group were not undergo drug preventive treatment.To detect five prothrombotic state parameters including D-Dimer,Fbg,PT,APTT,PLT before surgery and three days after surgery.Results The morbidity of DVT in treatment group obviously reduced than that in control groups（P0.05）.Compared the chang of serum levels of D-Dimer,Fbg before and after the thromboprophylaxis,these two parameters in treatment group were decreased significantly more than those in control group（P0.05）,but the change of PT,APTT,PLT had no statistical difference（P0.05）.Conclusion Preventive anticoagulation with low molecular heparin after cesarean section could reduce the incidence of deep venous thrombosis.