抗栓泵联合低分子肝素钙预防剖宫产术后下肢深静脉血栓的效果

Effect of antithrombotic pump combined with Low Molecular Weight Heparin Calcium in the prevention of deep venous thrombosis after caesarean section

目的探讨抗栓泵联合低分子肝素钙预防剖宫产术后下肢深静脉血栓(DVT)的效果。方法选取2015年4月~2017年4月我院收治的200例剖宫产术后高危DVT产妇作为研究对象,根据随机数字表法将其分为药物组和联合组,每组各100例。两组患者均给予常规干预和低分子肝素钙治疗,联合组另联用抗栓泵压力带预防DVT。比较两组患者治疗前后的血小板(PLT)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)及血液流变学指标变化,包括高切全血黏度(HBV)、低切全血黏度(LBV)、血浆黏度(PV)和纤维蛋白原(FIB),随访1个月,统计DVT和出血事件发生率。结果治疗后,两组患者的PLT和血液流变学指标水平均显著低于治疗前,TT显著短于治疗前,差异有统计学意义(P<0.05),两组患者治疗前后的PT、APTT比较,差异无统计学意义(P>0.05)。治疗后,联合组患者的PLT及各项血液流变学指标水平均显著低于药物组,TT显著短于药物组,差异有统计学意义(P<0.05)。联合组患者的DVT发生率远低于药物组,差异有统计学意义(P<0.05)。两组患者的出血事件发生率比较,差异无统计学意义(P>0.05)。结论剖宫产术后,采用抗栓泵联合低分子肝素钙能够改善凝血功能和血液流变学指标,降低DVT发生率,并且不会增加出血事件的发生风险。

Objective To explore the effect of antithrombotic pump combined with Low Molecular Weight Heparin Calcium in the prevention of deep venous thrombosis（DVT） after caesarean section. Methods A total of 200 cases of puerpera with high-risk DVT after cesarean section in our hospital from April 2015 to April 2017 were selected as objects and divided into drug group and combined group according to the random number table method, with 100 cases in each group. Routine intervention and Low Molecular Weight Heparin Calcium were given to each group, and the combined group was treated with anti thrombotic pump pressure band to prevent DVT. The platelet（PLT）, thrombin time（TT）, prothrombin time（PT）, activated partial thromboplastin time（APTT） and hemorheology indexes including high blood viscosity（HBV）, low shear blood viscosity（LBV）, plasma viscosity（PV） and fiber fibrinogen（FIB） in the two groups before and after treatment were compared. After 1 month of follow-up, the incidence of bleeding events and DVT were counted. Results The level of PLT and hemorheology indexs of two groups after treatment were significantly lower than those before treatment, TT was significantly shorter than that before treatment, and the differences were statistically significant（P〈0.05）. There were no statistically significant differences in PT and APTT between the two groups before and after treatment（P〈0.05）. After treatment, PLT and the level of hemorheology indexs in the combined group were significantly lower than those in the drug group, TT was significantly shorter than that in the drug group, and the differences were statistically significant（P〈0.05）. The incidence of DVT in the combined group was far lower than that of the drug group and the differences were statistically significant（P〈0.05）. There was no statistically significant difference in the incidence of bleeding events between the two groups（P〈0.05）. Conclusion After cesarean section, antithrombotic pump combined with Low Molecular Weight Heparin Calcium can improve coagulation function and hemorheology, reduce the incidence of DVT, which does not increase the risk of bleeding events.