低分子肝素钙在妇科肿瘤腹腔镜术后预防深静脉血栓中的临床效果

目的：探讨低分子肝素钙抗凝方案应用于妇科肿瘤腹腔镜术后预防深静脉血栓的临床效果以及安全性。方法：选择2011年1月-2014年12月120例实施妇科肿瘤腹腔镜术患者，按数字表法随机分为对照组与观察组，对照组54例患者不使用其他抗凝剂和影响凝血功能的药物；观察组66例患者实施低分子肝素钙皮下注射抗凝，持续10d，对比两组患者血清学指标、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、下肢周径、血流指标、并发症发生率。结果：观察组术后5d 纤维蛋白原、D -二聚体分别为（2.77±0.73）g/ L、（0.63±0.18）μg/ ml，均低于对照组，对比差异有统计学意义（P =0.019，P =0.029）；观察组术后3d、术后5d PT 分别为（13.85±3.93）s、（13.95±3.14）s，优于对照组，对比差异有统计学意义（P =0.042，P =0.034）；观察组下肢周径、血流速度分别为（20.33±3.52）cm、（0.95±0.18）m/ s，优于对照组，对比差异有统计学意义（P =0.021，P =0.019）；并发症发生率观察组3.03%（2/66）与对照组9.26%（5/54）对比差异有统计学意义（P =0.004）。结论：低分子肝素钙抗凝方案应用于妇科肿瘤腹腔镜术后可以有效改善患者血流状态，预防深静脉血栓形成。

Clinical effects of low molecular weight heparin in laparoscopic gynecologic oncology surgery for prevention of deep vein thrombosis

Objective:To investigate clinical effects of low molecular weight heparin in laparoscopic gynecologic oncology surgery for prevention of deep vein thrombosis. Methods:From 2011 to 2014,120 cases of laparoscopic sur-gery patients with gynecologic tumors were selected,they were divided into the control group and the observation group. 54 patients in the control group were implemented with no similar treatment,66 patients in the observation group were implemented with subcutaneous low molecular weight heparin anticoagulation for 10d. Two groups of anti- Xa activity,activated partial thromboplastin time(APTT),prothrombin time(PT),lower limb circumference,blood flow index,incidence of complications were compared. Results:In observed postoperative 5d fibrinogen,D - dimer was (2. 77 ± 0. 73)g/ L,(0. 63 ± 0. 18)μg/ ml,were lower than the control group,the difference was statistically signifi-cant(P = 0. 019,P = 0. 029). PT were(13. 85 ± 3. 93)s,(13. 95 ± 3. 14)s,higher than control group,the difference was statistically significant(P = 0. 042,P = 0. 034),in observation group lower limb circumference,blood flow veloci-ty were(20. 33 ± 3. 52)cm,(0. 95 ± 0. 18)m/ s,better than the control group,the difference was statistically signifi-cant(P = 0. 021,P = 0. 019). Observation group complication rate 3. 03%(2 / 66)and 9. 26%(5 / 54)in the control group had statistically significant difference(P = 0. 004). Conclusion:Low molecular weight heparin anticoagulation has good effect on blood flow for gynecologic cancer patients after laparoscopic surgery,for prevention of deep vein thrombosis.