低分子肝素钙联合丹参多酚酸盐预防妇科手术后下肢深静脉血栓形成的临床效果

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目的探究并分析低分子肝素(LMWH)钙联合丹参多酚酸盐预防妇科手术后下肢深静脉血栓形成(LEDVT)的临床效果。方法选取2015年1月-2016年1月该院妇科收治的100例行经腹或经阴道手术治疗的患者,按随机数表法将其分为观察组和对照组,每组各50例。对照组患者术后仅给予LMWH钙进行预防,观察组患者术后给予LMWH钙联合丹参多酚酸盐进行预防。比较两组患者术后LEDVT的预防效果。结果观察组患者术后LEDVT的发生率较对照组低[2.0%(1/50)vs30.0%(15/50)],两组比较差异有统计学意义(χ~2=14.58,P<0.05),而不良反应率组间比较差异无统计学意义(χ~2=0.34,P>0.05)。两组患者术后的纤维蛋白原(FIB)、血小板(PLT)检测值均较术前降低,手术前后比较差异有统计学意义(P<0.05),但术后组间比较差异无统计学意义(P>0.05);观察组术后的D-二聚体(D-D)、凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)值低于术前及对照组术后,手术前后及术后组间比较差异有统计学意义(P<0.05);术后,两组患者的血液黏度低切值和高切值比较差异有统计学意义(P<0.05);术后,观察组的下肢周径值小于对照组,血流速度大于对照组,组间比较差异有统计学意义(P<0.05)。结论 LMWH钙联合丹参多酚酸盐预防妇科手术后LEDVT的临床效果显著,可改善血流状态,降低LEDVT发生率,且安全性高,值得在临床上广泛应用。 Objective To investigate and analyze the clinical effect of low molecular weight heparin (LMWH) combined with salvianolate on the prevention of deep venous thrombosis (LEDVT) after gynecological surgery. Methods From January 2015 to January 2016, 100 cases undergoing gynecological operation in our hospital were randomly divided into observation group and control group according to random number table method, 50 cases in each group. Patients in the control group were given only LMWH calcium for prophylaxis. Patients in the observation group were given LMWH calcium combined with salvianolate for prevention. The preventive effects of LEDVT after operation were compared between the two groups. Results The incidence of postoperative LEDVT in the observation group was lower than that in the control group [2.0% (1/50) vs 30.0% (15/50)], with significant difference between the two groups (χ ~ 2 = 14.58, P < 0.05). There was no significant difference between adverse reaction rates (χ ~ 2 = 0.34, P> 0.05). The postoperative fibrinogen (FIB) and platelet (PLT) values ​​in both groups were significantly lower than those before operation (P <0.05), but there was no significant difference between the two groups after operation (P> 0.05). The postoperative D-dimer (DD), prothrombin time (PT) and partial prothrombin time (APTT) in the observation group were lower than those in the preoperative and postoperative (P <0.05). After operation, there was significant difference between the two groups in the low shear viscosity and the high shear value (P <0.05). After the operation, the observation group The peripheral diameter of lower extremities was lower than that of control group, and the velocity of blood flow was greater than that of control group. There was significant difference between the two groups (P <0.05). Conclusion LMWH combined with Salviae miltiorrhizae polyphenols in the prevention of postoperative gynecological surgery LEDVT significant clinical effect, can improve blood flow, reduce the incidence of LEDVT, and high safety, it is widely used in clinical.
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