摘要
目的探讨低分子肝素钙注射液联合逐级加压弹力袜在预防妇科腹腔镜手术后下肢深静脉血栓中的临床疗效。方法 2015年1月~2016年12月我院妇科因良性疾病接受腹腔镜手术80例,按照入院时间顺序编号,采用随机数字表分为2组:弹力袜组(n=40),术前开始使用逐级加压弹力袜;弹力袜联合低分子肝素组(n=40),术前开始使用逐级加压弹力袜,联合术后皮下应用低分子肝素钙注射液预防下肢深静脉血栓(lower extremity deep venous thrombosis,LEDVT)。比较2组患者术前和术后3 d白细胞、血小板、凝血时间、D-二聚体、LEDVT和肺栓塞发生率。结果 2组患者术后3 d白细胞、血小板、凝血时间比较差异无统计学意义(P>0.05)。D-二聚体弹力袜组中位数545.5μg/L(138.0~24 260.0μg/L),弹力袜联合低分子肝素组中位数365.0μg/L(52.0~9838.0μg/L),差异有统计学意义(Z=-2.098,P=0.036)。弹力袜组LEDVT发生率12.5%(5/40),与弹力袜联合低分子肝素组5.0%(2/40)比较差异无统计学意义(χ~2=0.626,P=0.429);弹力袜组肺栓塞发生率5.0%(2/40),弹力袜联合低分子肝素组2.5%(1/40),2组比较差异无统计学意义(χ~2=0.000,P=1.000)。结论接受妇科腹腔镜手术者使用逐级加压弹力袜联合术后皮下使用低分子肝素钙注射液,可降低术后D-二聚体,对预防妇科腹腔镜术后血栓的发生有指导意义,并有良好的安全性。
Objective To discuss the clinical efficacy of graduated compression stockings combined with low molecular heparin calcium injection in the prevention of deep venous thrombosis（ DVT） after gynecologic laparoscopic surgery. Methods This study selected 80 cases who were diagnosed of benign tumor and accepted laparoscopic surgery in our hospital from January 2015 to December 2016. According to the random number table,the patients were divided into stretch socks group（ n = 40） or stretch socks and heparin group（ n = 40）. The stretch socks group was given graduated compression stockings before the operation,and the stretch socks and heparin group was given graduated compression stockings before the operation combined with low molecular heparin calcium injection after operation. The levels of white blood cells,platelets,clotting time,and D-dimer and incidences of lower extremity deep venous thrombosis（ LEDVT） and pulmonary embolism before operation and 3 days after operation were compared between the two groups. Results There were no statistically significant differences in white blood cells,platelets,and clotting time between the two groups in 3-day postoperatively（ P〉0. 05）. The median levels of D-dimer were 545. 5 μg/L（ range,138. 0-24 260. 0 μg/L） in the stretch socks group and 365. 0 μg/L（ range,52. 0-9838. 0 μg/L） in the stretch socks and heparin group,the difference being statistically significant（ Z =-2. 098,P = 0. 036）. There was no significant difference in incidence of LEDVT between the stretch socks group（ 12. 5%,5/40） and the stretch socks and heparin group（ 5. 0%,2/40）（ χ^2= 0. 626,P = 0. 429）. There was no significant difference in pulmonary embolism between the stretch socks group（ 5. 0%,2/40） and stretch socks and heparin group（ 2. 5%,1/40）（ χ^2= 0. 000,P = 1. 000）. Conclusion In gynecologic laparoscopic surgery,graduated compression stockings combined with low molecular heparin calcium can reduce the level of D-dimer postoperatively,having
作者
张颖佳
刘思华
张军
Zhang Yingjia, Liu Sihua, Zhang Jun.(Department of Obstetrics and Gynecology, Beijing Anzhen Hospital of Capital Medical University, Beijing 100029, Chin)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第7期581-584,共4页
Chinese Journal of Minimally Invasive Surgery
