低分子肝素在剖宫产术后下肢深静脉血栓高危患者中的预防作用研究

Study on the preventive effect of low-molecular-weight heparin in patients with high risk of deep venous thrombosis after cesarean section

目的 研究低分子肝素在剖宫产术后下肢深静脉血栓(DVT)高危患者中的预防作用。方法 160例剖宫产术后下肢DVT高危患者,按随机数字表法分成观察组与对照组,各80例。对照组术后不给予药物干预,观察组在对照组基础上术后皮下注射低分子肝素钙。对比两组剖宫产术后下肢DVT发生率、凝血功能及产后出血发生情况。结果 观察组剖宫产术后下肢DVT发生率1.25%低于对照组的13.75%,差异有统计学意义(P<0.05)。术后,观察组纤维蛋白原(FIB)(4.42±0.96)g/L、D-二聚体(1.65±0.45)mg/L均低于对照组的(5.81±0.89)g/L、(2.37±0.46)mg/L,差异均具有统计学意义(P<0.05)。两组产后出血率对比,差异无统计学意义(P>0.05)。结论 低分子肝素通过降低剖宫产术后下肢DVT高危患者FIB、D-二聚体水平而减少DVT的发生率,而且不会增加产后出血。

Objective To study the preventive effect of low-molecular-weight heparin after cesarean section in patients with high risk of deep venous thrombosis(DVT)of the lower limbs.Methods A total of 160 patients with high risk of DVT of the lower limbs after cesarean section were randomly divided into observation group and control group,with 80 cases in each group.The control group was not given drug intervention,and the observation group was injected subcutaneously with low-molecular-weight heparin calcium.The incidence of DVT of the lower limbs after cesarean section,coagulation function,and occurrence of postpartum hemorrhage were compared between the two groups.Results The incidence of DVT of the lower limbs after cesarean section in the observation group was 1.25%,which was lower than that of 13.75%in the control group,and the difference was statistically significant(P<0.05).After surgery,the fibrinogen(FIB)of(4.42±0.96)g/L and D-dimer of(1.65±0.45)mg/L in the observation group were lower than those of(5.81±0.89)g/L and(2.37±0.46)mg/L in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postpartum hemorrhage between the two groups(P>0.05).Conclusion Lowmolecular-weight heparin can reduce the incidence of DVT by reducing the levels of FIB and D-dimer in patients with high-risk of DVT of the lower limbs after cesarean section,and does not increase postpartum hemorrhage.