低分子量肝素钙预防高危产妇剖宫产术后下肢深静脉血栓的临床效果

Clinical Effect of Low Molecular Weight Heparin Calcium on Prevention of Lower Extremity Deep Vein Thrombosis in High-risk Women after Cesarean Section

目的:探讨低分子量肝素钙预防高危产妇剖宫产术后下肢深静脉血栓的临床效果。方法:选取2021年1月—2022年12月深圳市宝安区妇幼保健院收治的下肢深静脉血栓高风险的剖宫产术后产妇1120例作为研究对象,随机分为对照组和观察组,各560例。对照组实施常规干预和气压治疗仪治疗,观察组在对照组基础上应用低分子量肝素钙治疗。比较两组下肢静脉血流速度、深静脉血栓发生率、血液流变学、凝血指标。结果:术后48 h、5 d、7 d,观察组全血高切黏度、血浆黏度、红细胞聚集指数、纤维蛋白原水平低于对照组,全血低切黏度高于对照组,差异有统计学意义(P<0.05)。术后7 d,两组股静脉血流峰值速度与平均速度高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组下肢静脉血栓总发生率低于对照组,差异有统计学意义(P=0.023)。结论:低分子量肝素钙预防高危产妇剖宫产术后下肢深静脉血栓的临床效果理想,可改善血液流变学、凝血指标,提高下肢静脉血流速度,降低深静脉血栓发生率。

Objective:To investigate the clinical effect of low molecular weight heparin calcium in preventing lower extremity deep vein thrombosis after cesarean section.Methods:A total of one thousand and one hundred and twenty women with high risk of deep venous thrombosis after cesarean section treated in Shenzhen Bao'an District Maternity and Child Health Hospital from January 2021 to December 2022 were selected as the study objects,and randomly divided into control group and observation group,five hundred and sixty cases in each group.The control group was treated with routine intervention and pneumatic therapy apparatus,and the observation group was treated with low molecular weight heparin calcium on the basis of the control group.Blood flow velocity,incidence of deep vein thrombosis,hemorheology and coagulation indexes were compared between the two groups.Results:48 h,5 d and 7 d after surgery,whole blood high tangential viscosity,plasma viscosity,red blood cell aggregation index and fibrinogen level in observation group were lower than those in control group,and whole blood low tangential viscosity was higher than those in control group,the difference was statistically significant(P<0.05).7 days after surgery,the peak velocity and average velocity of femoral vein blood flow in 2 groups were higher than before surgery,and the observation group was higher than the control group,the difference was statistically significant(P<0.05);The total incidence of lower limb venous thrombosis in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.023);Conclusion:Low molecular weight heparin calcium has ideal clinical effect in preventing lower extremity deep vein thrombosis after cesarean section in high-risk women.It can improve hemorheology and coagulation index increase the speed of lower extremity venous blood flow,reduce the incidence of deep vein thrombosis.