低分子肝素钙预防高危产妇剖宫产术后下肢静脉血栓的临床观察

Clinical Observation of Low Molecular Weight Heparin Calcium in Prevention of Lower Extremity Venous Thrombosis after High-Risk Maternal Cesarean Section

目的观察低分子肝素钙在预防高危产妇剖宫产术后下肢静脉血栓(DVT)的临床疗效。方法选择我院2016年1月~2018年12月具有下肢深静脉血栓形成高危因素的剖宫产分娩产妇120例,随机分为对照组和治疗组,各60例。对照组给予机械措施干预,治疗组在机械措施基础上给予低分子肝素钙干预。比较两组产妇术后凝血功能指标(PT、APTT、FIB、D-二聚体)PLT及产后出血量、DVT发生率。结果治疗组术后FIB、D-二聚体值低于对照组,APTT、PT均高于对照组,差异具有统计学意义(P<0.05);治疗组DVT发生率低于对照组,差异有统计学意义(P<0.05);两组PLT、产后出血量比较,差异无统计学意义(P>0.05)。结论低分子肝素钙可有效改善高危产妇术后血液高凝状态,预防高危产妇剖宫产术后下肢深静脉血栓形成,降低DVT发生率,且并不增加产后出血风险,治疗安全、有效,不影响母乳喂养,适于在临床工作借鉴应用。

Objective To observe the clinical efficacy of low molecular weight heparin calcium in the prevention of lower extremity venous thrombosis(DVT)after high-risk maternal cesarean section.Methods 120 patients with cesarean delivery who had high risk factors for deep venous thrombosis of lower extremity from January 2016 to December 2018 were randomly divided into control group and treatment group,60 cases each.The control group was given mechanical intervention,and the treatment group was given low molecular weight heparin calcium intervention based on mechanical measures.The postoperative coagulation function indexes(PT,APTT,FIB,D-dimer)PLT and the incidence of postpartum hemorrhage and DVT were compared between the two groups.Results The FIB and D-dimer values in the treatment group were lower than those in the control group,and the APTT and PT were higher than the control group,the difference was statistically significant(P<0.05).The incidence of DVT in the treatment group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in PLT and postpartum hemorrhage between the two groups(P>0.05).Conclusion Low molecular weight heparin calcium can effectively improve the postoperative hypercoagulability of high-risk maternal women,prevent deep venous thrombosis after high-risk maternal cesarean section,reduce the incidence of DVT,and does not increase the risk of postpartum hemorrhage.The treatment is safe and effective.Affect breastfeeding,suitable for reference in clinical work.