术后早期应用微量普通肝素对剖宫产患者血液流变性的影响

目的:探讨微量普通肝素对剖宫产患者术后早期血液流变性影响。方法:持续硬膜外麻醉下行剖腹取胎术40例,年龄25～30岁、ASAⅠ～Ⅱ级,随机分为肝素组（H组）和对照组（C组）,每组20例。H组术毕即刻进行48h微量普通肝素治疗。记录麻醉前5min（T₁）、术后1h（T₂）、6h（T₃）、24h（T₄）、48h（T₅）的高切变率全血粘度（Hηb）、低切变率全血粘度（Lηb）、血浆粘度（ηp）、全血还原粘度（ηr）、红细胞聚集指数（EAI）、红细胞变形指数（EDI）、红细胞刚性指数（ERI）、红细胞压积（Hct）、红细胞沉降率（ESR）、红细胞电泳时间（EET）。结果:T₃～T₅时H组Hηb、Lηb、ηr、EAI、ERI、EET明显降低（P<0.05）,T4、T₅时ηp也明显降低（P<0.05）,T₅时H组Hηb、Lηb、ηp、ηr、ERI、EET明显低于C组（P<0.05）。结论:术后早期剖宫产患者血液粘度增加,早期使用微量普通肝素治疗可改善剖宫产患者血液流变性,降低产后静脉血栓栓塞症发生率。

EFFECT OF EARLY APPLICATION OF MICREDOSAGE HEPARIN ON HEMORRHEOLOGY IN CAESAREAN PATIENTS AFTER OPERATION

Objective:To investigate the effect of early application of microdosage heparin on hemorrheology in postoperative caesarean patients.Methods:Fourty patients,physic status ASAⅠorⅡ,aged 25 to 30,underwent caesarean under epidural anesthesia,were randomly divided into heparin group（H）and control group（C）,20 in each group.Heparin was administrated immediately after operation in heparin group.High shear blood viscosity （Hηb）,low shear blood viscosity（Lηb）,plasma specific viscosity（ηp）,whole blood reductive viscosity（ηr）, erythrocyte aggregation index（EAI）,erythrocyte deformation index（EDI）,erythrocyte rigidity index（ERI）, erythrocyte sedimentation rate（ESR） and erythrocyte electrophoresis（EET） were measured 5 minutes（T₁）,1h（T₂）,6h （T₃）,24h（T₄） before anesthesia,and 48h after operation（T₅）.Noninvasive blood pressure and heart rate were observed and recorded at T_1～5.Visual analog pain scale scores（VAS） were observed and recorded at T_2～5.Results:①In group （H）,Hηb,Lηb,ηp,ηr,EET at T₃,T₄,T₅ were lower than those at T₁（P<0.05）,and EAI,ERI at T₅ were lower than those at T₁（P<0.05）.②In group C,blood rheology indexes at T₄,T₅ were higher than those at T₁,but without significance except EDI.③Hηb,Lηb,ηrEAI,ERI at T₅ in group H were lower than those in group C（P<0.05）.Conclusion: Blood viscosity in caesarean patients increases in early stage of postoperative period.Early application of micredosage heparin can improve the blood viscosity,thus decrease the pospartum incidence of venous thrombosis in caesarean patients