低分子肝素对高危妊娠孕产妇深静脉血栓形成的预防效果分析

Efficacy analysis of low molecular weight heparin for preventing the formation of deep vein thrombosis in high-risk gravida and parturient

目的探讨应用低分子肝素(LMWH)预防高危妊娠孕产妇孕期、产褥期深静脉血栓形成的效果。方法收集南方医科大学珠江医院2019年1月-2020年7月应用LMWH预防深静脉血栓形成的1099例高危妊娠病例作为LMWH组,选取2016年1月-2018年12月未使用LMWH的2107例高危妊娠病例作为对照组,比较分析两组血栓形成例数、产前及产后出血发生率、剖宫产率等指标。结果LMWH组无新发妊娠期及产褥期深静脉血栓,而对照组有新发血栓24例,两组比较差异有统计学意义(P=0.000)。LMWH组产前发生胎盘早剥2例,对照组产前发生胎盘早剥1例;LMWH组产后2 h出血量为(182.25±120.62)ml,对照组为(165.00±68.58)ml;LMWH组剖宫产率为37.5%,对照组为38.9%。两组胎盘早剥发生率、产后2 h出血量、剖宫产率等比较差异均无统计学意义(P>0.05)。结论对有血栓高危因素的孕产妇,根据评分使用LMWH可预防血栓形成,且安全有效。

Objective To investigate the curative effect of low molecular weight heparin(LMWH)on preventing the formation of deep vein thrombosis(DVT)of high-risk pregnant women during pregnancy and puerperium.Methods A total of 1099 high-risk pregnancy patients were collected as LMWH group who received LMWH for preventing the formation of DVT in Zhujiang Hospital of Southern Medical University from January 2019 to July 2020;and 2107 high-risk pregnancy cases without LMWH were selected as control group from January 2016 to December 2018.SPSS 20.0 was employed for statistical analysis,and the number of thrombosis cases,the incidence of prepartal and puerperal hemorrhage,the cesarean section rate and other indicators were compared and analyzed between the two groups.Results After LMWH treatment,no new case of DVT occurred in LMWH group during pregnancy and puerperium,while there were 24 cases of new thrombosis in control group,the difference was statistically significant between the two groups(P=0.000).There were 2 cases of placental abruption before delivery occurred in the LMWH group,and only 1 case in control group.The 2 h postpartum hemorrhage was(182.25±120.62)ml in LMWH group,and(165.00±68.58)ml in control group.The cesarean section rate was 37.5%in LMWH group and 38.9%in control group.No significant differences existed in the incidence of placental abruption,postpartum hemorrhage and cesarean section between the two groups(P>0.05).Conclusion For pregnant women with high risk factors for thrombosis,LMWH can be used according to the score to prevent thrombosis,and it is safe and effective.