乌司他丁预防腹腔镜手术患者术后深静脉血栓形成的临床研究

Clinical Study of Ulinastatin to Prevent Postoperative deep Venous Thrombosis in Patients Undergoing Laparoscopic Surgery

目的探讨分析乌司他丁预防腹腔镜手术患者术后深静脉血栓形成(DVT)的效果。方法对我院在2016年2月至2017年4月期间收治的行腹腔镜手术患者220例纳入研究对象,并对其所选患者的临床资料进行回顾性分析,根据治疗方式的不同,进行分组分为观察组(110例)与对照组(110例),观察组患者在术中给予静脉持续泵注1×10~5U/h乌司他丁,对照组给予患者等量的生理盐水治疗,分别在术前、后记录两组患者的凝血指标,凝血酶原时间(PT)及活化部分凝血活酶时间(aPTT)及凝血酶时间(TT)、纤维蛋白原(Fbg)和D二聚体(D-D)及深静脉血栓发生率、手术一般资料进行对比。结果观察组患者在麻醉及手术时间、术中出血量相比对照组均无明显差异(P> 0. 05),两组患者在手术前,凝血PT、aPTT、Fbg、TT、D-D的检查指标均无明显差异(P> 0. 05);手术后,两组患者的凝血时间(PT、aPTT、TT)变化不一,观察组倾向相对低凝,对照组倾向相对高凝(P <0. 05); Fbg、D-D检测增高(P <0. 05);观察组患者(血栓3例) DVT发生率为2. 73%明显低于对照组(血栓22例)发生率20. 00%,(P <0. 05)。结论在腹腔镜手术中给予患者乌司他丁治疗,能有效的缓解患者术后高凝状态,并有效的预防患者术后DVT。

Objective To investigate the effect of ulinastatin on postoperative deep venous thrombosis （DVT） in patients undergoing laparoseopie surgery. Methods In our hospital during February 2016 to April 2017 were laparoscopic surgery in 220 patients enrolled in the study,and the clinical data of the patients were retrospectively analyzed, according to different treatment methods,were divided into the observation group（ 110 cases）and control group （110 cases）, the observation group patients in the operation in the intravenous continuous infusion of 1×10^5U/h Ulinastatin, saline control patients in the treatment group received the same amount of record of coagulation indexes of two groups of patients before surgery,respectively, prothrombin time （PT） and activated partial thromboplastin time （ aPTT ） and thrombin time （ TT）, fibrinogen （ Fbg ） and two D- dimer （ D- D） and DVT were compared with operation rate, general information. Results The observation group patients in anesthesia and operation time,intraoperative blood loss compared with the control group had no significant difference（P 〉 0. 05 ）, two groups of patients before surgery, there were no significant difference between the indexes PT, aPTT, Fbg, blood TT, D- D （ P 〉 0. 05 ） ; After operation, there were different changes in coagulation time （aPTF,PT,TT）in the two groups, and the observation group tended to be relatively low in coagulation. In the control group, the relative hypercoagulability （ P 〈 0.05 ） , Fbg and D- D showed that the fibrinolytic activity in the two groups was higher （P 〈 0. 05 ） , and the incidence of DVT in the observation group（thrombosis in 3 cases,2.73% ）was significantly lower than that in the control group （22 eases,20. 00% ）（ P 〈 0.05 ）. Conclusion Ulinastatin can effectively relieve postoperative hypercoagulability and prevent postoperative DVT