神经外科手术后静脉血栓栓塞症预防性治疗研究

目的评估神经外科患者在围手术期皮下注射低分子肝素预防深静脉血栓栓塞症的安全性及有效性.方法实验组100例,术前12h至术后7d,每日皮下连续注射低分子肝素03ml.对照组100例,未行任何预防性抗凝措施.两组患者于术前和术后每隔7d分别行双下肢深静脉彩色超声多普勒检查,观察下肢深静脉血栓发生情况.结果实验组无深静脉血栓发生,术后血小板计数和凝血功能检查与手术前检查无显著性差异,无术后颅内出血者;对照组发生深静脉血栓10例(10%),1例发生症状性肺栓塞并死亡.结论神经外科患者在围手术期使用皮下注射低分子肝素预防深静脉血栓形成是安全有效的.

The study of safety and availability of prophylactic treatment for venous thromboembolism after neurosurgical operation

Objective To evaluate the safety and availability of prophylactic treatment for venous thromboembolism by hypodermic injection of low-molecule-weight heparin(LMWH) during peri-operation period. Methods 200 post-operation cases were examined in order to detect deep vein thrombosis(DVT) by color ultrasonic Doppler. Half of them were given hypodermic injection of 0.3ml LMH from 12 hours before operation to 7 days after operation, the other half were control group. Color ultrasonic Doppler examination of lower limb of both sides were done in all cases before operation and 7 days after operation to observe the occurence of DVT. Results No DVT occurred in the experimental group. The platelet count and coagulation time had no significant difference statistically, no post-operation intracranial hemorrhage occurred. While in the control group, DVT occurred in 10 cases and one of them developed PE and died finally. Conclusions Hypodermic injection of LMH during operative period is not only safe but also valid. But long-term, multi-center trial is needed to find the best treatment to prevent DVT formation time to use anti-coagulant medicine.