小剂量尿激酶联合低分子肝素防治伴高凝状态妇科肿瘤患者术后深静脉血栓形成的临床效果

Effects of Low-dose Urokinase combined with low molecular heparin on postoperative deep venous thrombosis formation in patients with hypercoagulable gynecological tumor

目的观察小剂量尿激酶联合低分子肝素防治伴高凝状态妇科肿瘤患者术后深静脉血栓(DVT)形成的临床效果。方法按照入院顺序将140例行手术治疗的伴高凝状态妇科肿瘤病例进行编号,将其分为观察组(单号)与对照组(双号)各70例,对照组只给予低分子肝素治疗,观察组给予小剂量尿激酶联合低分子肝素治疗,比较两组术后1h、术后7d凝血系统分子[纤维蛋白原(Fbg)、D-二聚体(D-D)、血管性假性血友病因子(vWF)、抗凝血酶复合物(TAT)、抗凝血酶(AT)]水平、凝血酶原时间(PT)与部分凝血活酶时间(APTT)、血小板聚集率、下肢周径值及血流速度、并发症情况、DVT发生率。结果术后7d,观察组Fbg、D-D、vWF、TAT水平、血小板聚集率明显低于对照组(P<0.05),AT明显高于对照组(P<0.05);观察组PT、APTT明显长于对照组(P<0.05),下肢周径值与血流速度均明显优于对照组(P<0.05);观察组术后并发症总发生率为1.43%、DVT发生率为0.00%显著低于对照组的10.00%和5.71%(P<0.05)。结论伴高凝状态的妇科肿瘤患者术后接受小剂量尿激酶联合低分子肝素治疗,能显著改善其凝血功能,有效抑制血小板大量聚集,优化下肢血流状态,降低DVT风险,且并发症少。

Objective To observe the effects of low-dose urokinase combined with low molecular heparin on postoperative deep venous thrombosis（DVT）formation in patients with hypercoagulable gynecological tumor.Methods 140 patients with hypercoagulable gynecological tumor treated with surgery in our hospital were numbered according to the order of admission and then divided into the observation group（single）and the control group（double）with 70 cases in each group.The control group was given low molecular heparin,and the observation group was given low-dose urokinase combined with low molecular heparin.The levels of coagulation system molecular[fibrinogen（Fbg）,D-dimer（DD）,von Willebrand factor（vWF）,antithrombin complex（TAT）,antithrombin（AT）],prothrombin time（PT）and activated partial thromboplastin time（APTT）,platelet aggregation rate,lower limb circumference value and blood flow velocity,complications and DVT incidence rate were measured and compared between the 2 groups at 1 hand 7 dafter operation.Results At 7 dafter operation,the levels of Fbg,D-D,vWF,TAT and platelet aggregation rate in the observation group were significantly lower than those in the control group（P〈0.05）,and AT level was significantly higher than that in the control group（P〈0.05）.The PT and APTT in the observation group were significantly longer than those in the control group（P〈0.05）,and the lower limb circumference value and the blood flow velocity were significantly better than those of the control group（P〈0.05）.The total incidence rate of postoperative complications and the incidence of DVT in the observation group were significantly lower than those in the control group[（1.43% vs.10%）and（0%vs.5.71%）]（P〈0.05）.Conclusion Low-dose urokinase combined with low molecular heparin can significantly improve i coagulation function,effectively inhibit platelet aggregation,and optimize lower limb blood flow and reduce DVT risk with less complications in patients with hypercoagulable gynecological tumor.