妇科恶性肿瘤术后应用低分子肝素钠联合间歇性气压装置预防下肢静脉血栓的效果评价

Efficacy Evaluation of Low Molecular Weight Heparin Sodium Combined with Intermittent Pneumatic Compression in the Prevention of Lower Extremity Venous Thrombosis after Gynecological Malignant Tumor Surgery

目的:分析评价妇科恶性肿瘤术后应用低分子肝素钠联合间歇性气压装置预防双下肢静脉血栓的效果。方法:选取2019年1月-2021年1月厦门大学附属中山医院收治的150例妇科恶性肿瘤患者,按照随机数字表法将其分为观察组和对照组,每组75例。观察组术后采用低分子肝素钠联合间歇性气压装置治疗,对照组术后仅采用间歇性气压装置治疗。比较两组双下肢肿痛、静脉血栓及出血发生率,比较两组凝血功能指标、D-D及血小板、血红蛋白(Hb)水平。结果:观察组下肢肿痛及静脉血栓发生率均低于对照组,差异均有统计学意义(P<0.05)。两组切口血肿、局部皮肤瘀斑发生率比较,差异均无统计学意义(P>0.05)。术前,两组PT、APTT、FIB、PLT、D-D及Hb比较,差异均无统计学意义(P>0.05)。术后7 d,两组PT、APTT、PLT、Hb水平比较,差异均无统计学意义(P>0.05)。术后7 d,观察组FIB、D-D水平均低于对照组,差异均有统计学意义(P<0.05)。结论:妇科恶性肿瘤患者术后应用低分子肝素钠联合间歇性气压装置可有效改善患者血清学指标,降低VTE风险,安全性较高,临床推广应用前景良好。

Objective:To analyze and evaluate the effect of Low Molecular Weight Heparin Sodium combined with intermittent pneumatic compression in the prevention of lower extremity venous thrombosis after gynecological malignant tumor surgery.Method:A total of 150 patients with gynecological malignant tumor admitted to Zhongshan Hospital Affiliated to Xiamen University from January 2019 to January 2021 were selected,and they were divided into observation group and control group according to random number table method,75 cases in each group.The observation group was treated with Low Molecular Weight Heparin Sodium combined with intermittent pneumatic compression after surgery,while the control group was treated with intermittent pneumatic compression only after surgery.The incidence of lower limb swelling and pain,venous thrombosis and hemorrhage were compared between two groups,and the coagulation function indexes,D-D,platelet and hemoglobin(Hb)levels were compared between two groups.Result:The incidence of lower limb swelling and pain and venous thrombosis in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).There were no significant differences in the incidence of incision hematoma and localized ecchymosis of the skin between two groups(P>0.05).Before surgery,there were no significant differences in PT,APTT,FIB,PLT,D-D and Hb between two groups(P>0.05).7 d after surgery,there were no significant differences in PT,APTT,PLT and Hb between two groups(P>0.05).7 d after surgery,FIB and D-D in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Postoperative application of Low Molecular Weight Heparin Sodium combined with intermittent pneumatic compression in patients with gynecological malignant tumor can effectively improve the serological indicators of patients,reduce the risk of VTE,with high safety and good clinical application prospect.