低分子肝素在预防妇科术后血栓的围手术期应用

Perioperative Application of Low Molecular Heparin in the Prevention of Thrombosis after Gynecological Surgery

目的探讨低分子肝素应用于预防妇科术后血栓的临床效果。方法选取我院2013年11月到2016年11月期间收治的50例行妇科手术(均为三级以上手术)的患者,随机分为对照组和治疗组,各25例。对照组嘱其早下床活动以预防血栓,治疗组在此基础上于围手术期预防性使用低分子肝素。比较两组患者的血栓发生率和凝血功能指标情况。结果治疗组的血栓发生率为4.0%,明显低于对照组的24.0%(P<0.05)。术前,两组患者的凝血功能指标比较差异无统计学意义(P>0.05);术后,治疗组的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间均显著长于对照组(P<0.05),D二聚体、纤维蛋白原水平均显著低于对照组(P<0.05)。结论在围手术期预防性应用低分子肝素可有效降低患者妇科手术后的血栓发生率。

Objective To explore the clinical effect of low molecular heparin in the prevention of thrombosis after gynecological surgery. Methods 50 cases of patients undergoing gynecological surgery （more than 3 levels） in our hospital from November 2013 to November 2016 were selected and divided into control group and treatment group, with 25 cases in each group. The control group was told early ambulation to prevent thrombosis, while the treatment group received preventive low molecular heparin in the perioperative period on this basis. The incidence of thrombosis and indicators of blood coagulation were compared between two groups. Results The incidence of thrombosis of treatment group was 4.0%, significantly lower than 24.0% of control group （P〈0.05）. Before surgery, no statistical difference was found in the indicators of blood coagulation between two groups （P 〉0.05）. After surgery, the prothrombin time, thrombin time and activated partial thromboplastin time of treatment group were significantly longer than those of control group （P〈0.05）, and D dimer and ~brinogen levels were significantly lower than those of control group （P 〈0.05）. Conclusions Preventive low molecular heparin in the perioperative period can effectively reduce the incidence of thrombosis after gynecological surgery.