低分子肝素联合右旋糖酐与单用低分子肝素在妇科术后下肢深静脉栓塞的临床效果比较

目的比较低分子肝素联合右旋糖酐与单用低分子肝素应在妇科术后下肢深静脉栓塞治疗中的临床效果。方法选择2011年1月～2013年6月浙江省舟山医院收治的妇科术后下肢深静脉栓塞患者100例随机分为对照组和观察组，每组各50例。在常规治疗基础上，对照组给予低分子肝素治疗，观察组在对照组治疗基础上加用右旋糖酐。比较两组患者治疗前后凝血指标的变化、患肢肿胀的改善程度及临床疗效。结果①观察组患者的总有效率（88．0％）明显高于对照组（64．0％），差异有高度统计学意义（P〈0．01）；②治疗后观察组患者的凝血酶原时间、活化部分凝血酶时间及凝血酶时间明显低于治疗前及对照组，差异有统计学意义（P〈0．05）；⑧观察组治疗5～7d后患肢的肿胀消退率（74．0％）明显高于对照组（32．0％），2～3周患肢的恢复正常率（90．0％）明显高于对照组（62．0％），差异均有统计学意义（P〈0．05）。结论低分子肝素联合右旋糖酐治疗妇科术后下肢深静脉栓塞，具有临床疗效显著、安全可靠等优点，值得临床推广和应用。

Comparison of clinical effect of low molecular weight heparin combined with dextran and low molecular weight heparin alone in treatment of low- er extremity deep venous thrombosis after gynecological surgery

Objective To compare effects of low molecular weight heparin combined with dextran and low molecular weight heparin in treatment of lower extremity deep venous thrombosis after gynecological surgery. Methods Totally 100 patients with lower extremity deep venous thrombosis after gynecological surgery in Zhoushan hospital from January 2011 to June 2013 were randomly divided into control group and observation group, with 50 cases in each group. Based on the conventional treatment, the control group was treated by low molecular weight heparin, and the observation group was treated by low molecular weight heparin combined with dextran. Changes of coagulation parameters before and after treatment, the degree of improvement in limb swelling and clinical efficacy of two groups were compared. Results ①The total rate of clinical effective of the observation group （88.0%） was significantly higher than that of con- trol group （64.0%）, the difference was statistically significant （P 〈 0.01）; ②PT, APTT and TT of observation group after treatment were lower than those before treatment and control group, the differences were statistically significant （P 〈 0.05）; ③The swelling rate of observation group （74.0%） was significantly higher than that of control group （32.0%） after 5-7 days, the difference was statistically significant （P 〈 0.05）. The recovery rate of observation group （90.0%） was sig- nificantly higher than that of control group （62.0%） after 2-3 weeks, the difference was statistically significant （P 〈 0.05）. Conclusion Low molecular weight heparin combined with dextran in treatment of lower extremity deep venous thrombosis after gynecological surgery is effective, safe and reliable. It is worthy of clinical application.