低分子肝素钙在妇科肿瘤腹腔镜术后预防深静脉血栓中的临床效果

Clinical Efficacy of Low Molecular Weight Heparin Calcium in the Prevention of Deep Vein Thrombosis after Laparoscopic Surgery for Gynecological Tumors

目的评价低分子肝素钙在妇科肿瘤腹腔镜术后预防深静脉血栓中的临床效果。方法方便选择福建医科大学附属肿瘤医院妇科肿瘤科2017年1—12月收治的患者124例,随机分为对照组、观察组各62例,分别给予常规DVT预防护理以及在此基础上联合低分子肝素钙。对比观察组与对照组疗效指标。结果观察组下肢症状发生率14.5%低于对照组43.5%,差异有统计学意义(χ~2=12.68,P=0.000<0.05)。观察组术后72 h血栓弹力图MA、术后膝上15 cm周径增加峰值、术后膝下15 cm周径增加峰值、术后1周内D-二聚体峰值分别为(81.2±6.4)、(2.6±0.4)cm、(2.1±1.3)cm、(3.1±0.7)mg/L,低于对照组(86.4±4.5)、(3.7±1.5)cm、(3.8±1.1)cm、(4.4±1.1)mg/L,差异有统计学意义(t=6.72、3.97、4.11、3.87,P=0.000、0.001、0.000、0.001<0.05)。结论低分子肝素钙尽管不能降低DVT发生率,但是可以降低DVT发生风险。

Objective To evaluate the clinical effect of low molecular weight heparin calcium in the prevention of deep venous thrombosis after laparoscopic surgery for gynecological tumors. Methods A gynecologic oncology department of the Affiliated Tumor Hospital of Fujian Medical University was selected from January to December 2017. 124 patients were convenient selected and divided into a control group and an observation group of 62 patients. The patients were given routine DVT preventive care and were combined on this basis with molecular heparin calcium. The efficacy indexes of the observation group and the control group were compared. Results The incidence of lower limb symptoms in the observation group was 14.5%, which was lower than that in the control group（43.5%）. The difference was statistically significant（χ^2=12.68,P=0.0000.05）. In the observation group, the postoperative thromboelastogram MA, the increase of the 15 cm circumference of the knee after the operation, the increase of the 15 cm circumference of the knee after the operation, and the peak of Ddimer in the first postoperative week were（81.2±6.4）,（2.6±0.4） cm,（2.1±1.3） cm,（3.1±0.7） mg/L lower than the control group（86.4±4.5）,（3.7±1.5） cm,（3.8±1.1）cm,（4.4±1.1） mg/L, the difference was statistically significant（t=6.72, 3.97, 4.11, 3.87,P=0.000, 0.001, 0.000, 0.001 0.05）. Conclusion Although low molecular weight heparin calcium can not reduce the incidence of DVT, it can reduce the risk of DVT.