低分子量肝素对腹腔镜下胆囊切除术后深静脉血栓形成的预防价值

Value of low molecular weight heparin in preventing deep vein thrombosis after laparoscopic cholecystectomy

目的探讨低分子量肝素对腹腔镜下胆囊切除术后深静脉血栓(DVT)形成的预防价值。方法收集2019年3月至2022年12月于海口市第四人民医院住院接受腹腔镜下胆囊切除术的98例患者的临床资料,并根据术后是否使用低分子量肝素将患者分为肝素组(n=45)和对照组(n=53)。比较两组患者的胆囊疾病分布情况、手术相关指标、术后住院期间DVT发生情况、D-二聚体水平复查结果、凝血酶原时间和活化部分凝血活酶时间。结果两组患者的胆囊疾病分布情况、手术相关指标比较,差异均无统计学意义(P﹥0.05)。术后住院期间,肝素组患者的DVT发生率低于对照组患者,D-二聚体水平升高的比例低于对照组患者,差异均有统计学意义(P﹤0.05);两组患者的凝血酶原时间和活化部分凝血活酶时间比较,差异均无统计学意义(P﹥0.05)。两组患者术后住院期间均未发生明显出血的现象。结论低分子量肝素可以安全有效地降低腹腔镜下胆囊切除术后患者DVT形成的风险。

Objective To explore the preventive value of low molecular weight heparin in deep vein thrombosis(DVT)after laparoscopic cholecystectomy.Method Clinical data of 98 patients who received laparoscopic cholecystectomy in the Fourth People's Hospital of Haikou from March 2019 to December 2022 were collected,according to usage of low molecular weight heparin after surgery,the patients were divided into heparin group(n=45)and control group(n=53).The distribution of gall bladder diseases,surgery related indicators,occurrence of DVT during hospitalization after surgery,D-dimer test results,prothrombin time and activated partial thromboplastin time were compared in two groups.Result There was no significant difference in the distribution of gall bladder diseases and surgery related indicators between the two groups(P>0.05).During the postoperative hospitalization,the incidence rate of DVT in the heparin group was lower than that in the control group,the proportion of patients with elevated D-dimer levels in the heparin group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no statistically significant difference in prothrombin time and activated partial thromboplastin time between the two groups(P>0.05).Both groups of patients did not experience significant bleeding during postoperative hospitalization.Conclusion Low molecular weight heparin can safely and effectively reduce the risk of DVT formation after laparoscopic cholecystectomy.