皮下注射低分子肝素钙对危重烧伤患者下肢静脉血栓的预防效果

Preventive effect of subcutaneous injection of low molecular weight hep-arin calcium on lower extremity venous thrombosis in critically burned patients

目的探讨皮下注射低分子肝素钙对危重烧伤患者下肢静脉血栓的预防效果。方法选择2016年1月~2019年4月在医院治疗的重度烧伤患者60例的临床资料进行回顾性分析。60例患者随机分为观察组与对照组各30例。对照组给予常规治疗,观察组在此基础上给予低分子肝素钙皮下注射治疗。比较两组治疗前后外周血纤维蛋白原、D-二聚体、血小板水平。比较两组感染率及血栓形成率。结果(1)治疗后3 d、5 d、10 d及15 d观察组纤维蛋白原水平显著低于对照组,差异有统计学意义(P<0.05)。(2)治疗后3 d、5 d、10 d及15 d观察组D-二聚体水平显著低于对照组,差异有统计学意义(P<0.05)。(3)治疗后3 d、5 d、10 d及15 d观察组血小板水平与对照组比较差异无统计学意义(P>0.05)。(4)两组感染发生率比较差异无统计学意义(P>0.05)。观察组无血栓形成,对照组有4例下肢静脉血栓形成,发生率为13.3%,两组比较差异有统计学意义(P<0.05)。结论皮下注射低分子肝素钙可降低危重烧伤患者的纤维蛋白原水平、D-二聚体水平,改善患者高凝状态,从而有效预防下肢静脉血栓的形成。

Objective To investigate the preventive effect of the subcutaneous injection of low molecular weight heparin calcium on the lower extremity venous thrombosis in critically burned patients.Methods The clinical data of 60 patients with severe burns treated in hospital from January 2016 to April 2019 were analyzed retrospectively.The 60 patients were randomly divided into the observation group and the control group,with 30 patients in each group.The control group was given conventional treatment,on the basis of which the observation group was given subcutaneous injection of low molecular weight heparin calcium.Peripheral blood fibrinogen,D-dimer and platelet levels of the two groups before and after treatment were compared.The infection rates and thrombosis rates of the two groups were compared.Results(1)The fibrinogen levels in the observation group were significantly lower than those in the control group at day 3,day 5,day 10 and day 15 of treatment,with statistically significant differences(P<0.05).(2)The D-dimer levels in the observation group were significantly lower than those in the control group at day 3,day 5,day 10 and day 15 of treatment,with statistically significant differences(P<0.05).(3)There were no significant differences in the platelet levels between the two groups at day 3,day 5,day 10 and day 15 after treatment(P>0.05).(4)There was no significant difference in the incidence of infection between the two groups(P>0.05).There was no thrombosis in the observation group and 4 cases of lower extremity venous thrombosis in the control group,with the incidence rate of 13.3%,with statistically significant difference between the two groups(P<0.05).Conclusion Subcutaneous injection of low molecular weight heparin calcium can reduce the fibrinogen and D-dimer levels in critically burned patients and improve the hypercoagulability,thus effectively preventing the formation of lower extremity venous thrombosis.