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目的:研究和探索低分子肝素钙联合气压治疗在预防妇科肿瘤术后下肢深静脉血栓(DVT)的临床效果和应用价值。方法:2013年1月至2016年6月佛山市顺德区第一人民医院妇科恶性肿瘤实施经腹、经腹腔镜手术术后病人共180例,分A组、B组、C组。A组60例未采用预防血栓措施;B组60例采用气压治疗;C组60例采用低分子肝素钙联合气压治疗。对比观察3组患者术后临床症状,包括下肢肿胀、下肢疼痛、下肢血管彩色多谱勒测定血流速度、血栓形成,及对比3组术后3 d、5 d血清学指标,包括纤维蛋白原(FIB)、D-二聚体、凝血酶原时间(PT)。结果:A组DVT发生率3.33%,B组1.67%,C组0%;C组患者术后纤维蛋白原、D-二聚体和凝血酶原时间等血清指标明显优于A和B组,差异具有统计学意义(P<0.05)。结论:低分子肝素联合气压治疗的施行,能够明显降低妇科肿瘤术后下DVT的发生率,提高整体治疗和护理效果。
Objective: To study and explore the clinical effect and application value of low molecular weight heparin combined with bariatric airway pressure in preventing postoperative deep vein thrombosis (DVT) of gynecologic tumor. Methods: From January 2013 to June 2016, 180 cases of patients with gynecological malignant tumors of the First People’s Hospital of Shunde District of Foshan City were enrolled in this study. The patients were divided into groups A, B and C after laparoscopic surgery. A group of 60 patients did not take measures to prevent thrombosis; B group 60 patients with pressure treatment; C group 60 patients with low molecular weight heparin calcium combined with pressure treatment. The clinical symptoms, including lower extremity swelling, lower extremity pain, blood flow velocity and thrombosis in lower extremity blood vessels were observed and compared among the three groups. Serum indexes including 3 days and 3 days after operation were compared among the three groups, including fibrinogen (FIB), D-dimer, prothrombin time (PT). Results: The incidence of DVT was 3.33% in group A, 1.67% in group B and 0% in group C. The serum indexes of fibrinogen, D-dimer and prothrombin time in group C were significantly better than those in group A and B, The difference was statistically significant (P <0.05). Conclusion: The application of low molecular weight heparin combined with bariatric therapy can significantly reduce the incidence of DVT after gynecologic tumor surgery, and improve the overall treatment and nursing effect.