低分子肝素钙联合丹参注射液对剖宫产术后下肢深静脉血栓患者凝血功能及D-二聚体水平影响

Effect of low molecular weight heparin calcium on coagulation function and D-dimer level in patients with deep venous thrombosis after cesarean section

目的探讨低分子肝素钙联合丹参注射液对剖宫产术后下肢深静脉血栓患者凝血功能及D-二聚体水平的影响。方法选取2010年8月到2016年8月在本院接受下肢深静脉血栓治疗的产妇188例,所有患者均为手术后3 d内发现深静脉血栓。依据随机数字表法将患者分成观察组和对照组各94例。对照组于剖宫产后第4天进行皮下注射低分子肝素钙5 000 IU,每日一次,连续5 d;观察组在对照组基础上注射丹参注射液;注射前和注射后第5天检测两组患者的纤维蛋白原浓度和D-二聚体水平变化以及凝血酶原时间(PT)、下肢周径、术后血流速度。结果注射低分子肝素钙及丹参注射液后5 d,两组患者纤维蛋白原浓度、D-二聚体水平、PT、下肢周径和术后血流速度均有明显变化,且与注射前对比差异有统计学意义(P<0.05);观察组各项指标的变化幅度均大于对照组,两组对比差异有统计学意义(P<0.05)。结论低分子肝素钙联合丹参注射液能够有效改善剖宫产术后下肢深静脉血栓患者凝血功能,降低血浆中D-二聚体浓度水平。

Objective To investigate the effect of low molecular weight heparin calcium on coagulation function and Ddimer level in patients with deep venous thrombosis after cesarean section.Methods A total of 188 women with deep venous thrombosis treated by our hospital from August 2010 to August 2016 were enrolled in this study.All patients were found to have deep vein thrombosis within 3 days after surgery.The patients were divided into two groups according to the random number table method：94 cases in the observation group and 94 cases in the control group.The control group was injected with low molecular weight heparin calcium 5 000 IU on the fourth day after cesarean section once a day for 5 days.In addition to the treatment of control group,the observation group was injected with Salvia miltiorrhiza.Before injection and on the 5 th days after injection,the fibrinogen and D-dimer levels,prothrombin time（PT）,peripheral length of the lower extremities,and postoperative blood flow velocity were measured in both groups.Results After injection of low molecular weight heparin calcium and Salvia miltiorrhiza injection,the fibrinogen concentration,D-dimer level,PT,lower limb circumference,and postoperative blood flow velocity were significantly changed in the two groups at 5 days after injection（P〈0.05）.The change extent of each index in the observation group was greater than that of the control group,and the difference between the two groups was statistically significant（P〈0.05）.Conclusion Low molecular weight heparin calcium combined with Salvia miltiorrhiza injection could effectively improve the coagulation function of patients with deep vein thrombosis of lower extremities after cesarean section and reduce plasma D-dimer concentration.