妊娠期高血压疾病术后抗凝治疗的临床研究

Clinical Research of Postoperative Anticoagulant Therapy for Gestational Hypertension

目的探讨妊娠期高血压疾病术后采用不同抗凝药物治疗后的抗凝效果。方法选取2008年12月至2013年12月在元氏县医院住院治疗的240例妊娠期高血压疾病术后患者为研究对象,采用随机数字表法分为两组,每组120例,其中低分子肝素钙组给予低分子肝素钙脐周皮下注射;联合治疗组采用低分子肝素钙联合应用右旋糖酐20治疗。比较两组患者治疗后栓塞及出血情况。结果分子肝素钙组深静脉栓塞及肺栓塞的发生率显著高于联合治疗组(χ2=5.352、4.352,P<0.05),低分子肝素钙组患者伤口出血量及阴道出血量与联合治疗组比较,差异均无统计学意义(P>0.05);低分子肝素钙组患者注射部位出血例数及血肿形成例数与联合治疗组比较,差异无统计学意义(P>0.05)。结论右旋糖酐20葡萄糖注射液联合低分子肝素钙用于妊娠期高血压疾病术后的抗凝效果优于单独应用低分子肝素钙,且并不增加不良反应,值得临床推广应用。

Objective To investigate the effect of postoperative anticoagulant therapy for gestational hypertension. Methods A total of 240 cases of gestational hypertension hospitalized in Yuanshi County Hospital from Dec. 2008 to Dec. 2013 were selected as study objects, according to the random number table, the patients were divided into two groups, 120 patients in each group. Low molecular weight heparin group received low molecular heparin calcium subcutaneous injections, combination therapy group was given low molecular heparin calcium and dextran 20. The incidence rate of embolism and bleeding after treatment were compared. Results The incidences of deep vein thrombosis and pulmonary embolism of low molecular weight heparin group were significantly higher than the combined treatment group （ X2 = 5. 352,4. 352, P 〈 0.05 ） ; there was no statistically significantly difference between the volume of wound bleeding and vagi- nal bleeding of the two groups （P 〉 0.05 ） , the cases of injection site hemorrhage and haematoma formation between the two groups had no statistically significant difference （ P 〉 0.05 ）. Conclusion The effect of dextran 20 glucose injection ＋ low molecular weight heparin calcium for treatment of gestational hypertension postoperative is better than low molecular weight heparln alone, with no extra adverse reactions, thus is worthy of clinical application.