拜阿司匹灵联合气压治疗仪预防剖宫产后下肢静脉血栓形成的效果

Effect of aspirin combined with barotherapy on prevention of lower extremity venous thrombosis after cesarean section

目的探究拜阿司匹灵联合气压治疗仪对改善剖宫产后凝血功能状况及预防下肢静脉血栓形成的效果。方法回顾性分析2017年1月至2018年9月渭南市妇幼保健院产科收治的150例足月产妇的临床资料,按照产妇剖宫产术后治疗方法的不同将产妇分为A组、B组和C组,每组50例。在同等基础支持治疗的方法上,A组采用拜阿司匹灵治疗,B组采用气压治疗仪治疗,C组采用拜阿司匹灵联合气压治疗仪治疗,三组产妇均治疗5d后比较其血栓形成情况、术后疼痛度、切口愈合时间和静息心指数(CI)、双下肢肿胀指数、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)。结果C组产妇术后凝血功能指标APTT、PT、TT分别为(22.32±2.74)s、(9.54±2.43)s、(9.87±4.85)s,均明显低于A组的(26.32±2.44)s、(11.24±2.76)s、(12.34±3.46)s和B组的(28.23±2.47)s、(12.54±2.48)s、(13.64±3.87)s,差异均有统计学意义(P<0.05);C组产妇术后血栓总形成率为4.0%,明显低于A组的24.0%和B组的18.0%,差异有统计学意义(P<0.05);C组产妇术后的VAS评分为(1.53±1.14)分,明显低于A组的(2.21±1.46)分和B组的(2.18±1.53)分,差异均有统计学意义(P<0.05);A组、B组、C组产妇的切口愈合时间分别为(6.56±2.36)d、(6.54±2.33)d、(6.52±2.31)d,差异无统计学意义(P>0.05);A组、B组、C组产妇的静息CI分别为(3.52±1.45)、(3.48±1.42)、(2.34±1.21),差异有统计学意义(P<0.05);A组、B组、C组产妇的双下肢肿胀指数分别为(8.32±2.44)、(8.26±2.36)、(3.53±2.12),差异均有统计学意义(P<0.05)。结论拜阿司匹灵联合气压治疗仪治疗剖宫产术后产妇能够降低产妇术后下肢静脉血栓形成发生率,有助于减轻术后疼痛,减少静息CI和双下肢肿胀指数,值得临床应用推广。

Objective To investigate the effect of aspirin combined with barotherapy on improving blood coagulation function and preventing lower extremity venous thrombosis after cesarean section. Methods Clinical data of 150 full-term maternal patients admitted to the Department of Obstetrics at Weinan Maternal and Child Health Hospital from January 2017 to September 2018 were retrospectively analyzed. According to the different treatment methods after cesarean section, the patients were divided into group A, group B and group C, with 50 cases in each group. On the basis of the same basic supportive treatment, group A was treated with aspirin, group B was treated with barotherapy, group C was treated with aspirin and barotherapy. All the three groups were treated for 5 days, and then the thrombosis, postoperative pain degree, incision healing time, static cardiac index (CI), bilateral lower limbs swelling index, activated partial thromboplastin time (APTT), prothrombin time (PT), and the thrombin time (TT) were compared. Results The postoperative coagulation function indexes in group C were APTT (22.32±2.74) seconds, PT (9.54±2.43) seconds, and TT (9.87±4.85) seconds, which were significantly lower than APTT (26.32±2.44) seconds, PT (11.24±2.76) seconds, and TT (12.34±3.46) seconds in group A and APTT (28.23±2.47) seconds, PT (12.54±2.48) seconds and TT (13.64±3.87) seconds in group B (P<0.05). The total thrombosis rate of postpartum women in group C was 4.0%, which was significantly lower than 24.0% in group A and 18.0% in group B (P<0.05). The postoperative VAS score of the delivery women in group C was 1.53±1.14, which was significantly lower than 2.21±1.46 in group A and 2.18±1.53 in group B (P<0.05). The incision healing time in group A, B and C were (6.56±2.36) days,(6.54±2.33) days, and (6.52±2.31) days, respectively (P>0.05). The static CI in group A, B and C were 3.52±1.45, 3.48±1.42, and 2.34±1.21, respectively (P<0.05). The bilateral lower limbs swelling index in the three groups were 8.32±2.44, 8.26±2.36, 3.53±2.12, and all differences were statistically significant (P< 0.05). Conclusion The combined use of aspirin and barotherapy in the treatment of postpartum women after cesarean section can reduce the incidence of postoperative lower extremity venous thrombosis, help reduce postoperative pain, reduce static CI and bilateral lower limbs swelling index, which is worthy of clinical application promotion.