应用LMWH预防性抗凝致术后出血与妇科手术方式的相关性

目的探讨妇科术后应用低分子肝素(LMWH)进行预防性抗血栓形成引起术后出血与不同手术方式的相关性。方法回顾性分析2016年1月至2019年12月行妇科手术的600例患者临床资料<结果出血百分率:A1组15%、A2组4%、B1组7%、B2组2%、C1组5%、C2组4%o实验组比较,A1组较Bl、C1组明显增高(P<0.05),El、Cl组比较及A2、B2、C2组间比较无明显差异(P>0.05)。比较高血压、糖尿病及HES-BLED评分工3者百分数,A1组高于B1、C1组(P<0.05),A2组高于B2、C2组(P<0.05);Al、A2之间,B1、C1之间及B2、C2之间进行组间比较差异无显著性(P>0.05)。比较患者年龄、平均动脉压、肌肝清除率,A1、B1、C1三组之间及A2、B2、C2三组之间比较差异均有统计学意义(P<0.05)。6组之间国际标准化比值差异无显著性(P>0.05)。结论应用LMWH致术后出血与妇科手术方式有相关性,应用LMWH后,经阴道双侧舐棘韧带固定加阴道前后壁修补术较腹腔镜卵巢囊肿剥除术和子宫肌瘤剔除术后出血的百分率明显增高。

Objective To explore the relativity of applying LMWH prophylactic anticoagulation lead hemorrhage via different Gynecological operations.Methods The clinical data of 600 patients who underwent gynecological operations in our hospital from January 2016 to December 2019 were retrospectively analyzed.Results The percentage of bleeding patients in each group:A1(15%);A2(4%);B1(7%);B2(2%);C1(5%);C2(4%).The percentage of bleeding patients in group Al was significantly higher than that of B1 and C1(P<0.05).There was no statistical difference between B1 and C1(P>0.05).There was no significant difference between A2,B2 and C2 each other(P>0.05).There was significant difference between Al and Bl,Al and C1,A2 and B2,A2 and C2 in hypertension,diabetes and HES—BLED M 3 score(P<0.05).There were statistical differences in age,MAP and CCR among A1,B1,C1 and among A2,B2,C2(P<0.05);there was no significant difference in the I NR among the six groups(P>0.05).Conclusion The Percentage of bleeding after applying with LMWH is related to the way of gynecological operation.The operation of trans vaginal fixation of sacral spine ligament and repair of anterior and posterior wall of vagina has a higher bleeding percent than Laparoscopic ovariectomy and laparscopic hysteromyomectoniy.