摘要
目的 探讨低分子肝素钙与下肢气压治疗的早期应用对预防剖宫产术后下肢静脉血栓形成的效果。方法 选取2018年1月到2020年1月在山东第一医科大学第二附属医院产科行剖宫产手术并成功分娩的224例产妇,按其住院次序给予编号,在随机数字表中取随机数,所对应的随机数字表的序号为奇数的定为观察组(112例),偶数定为对照组(112例)。2组产妇剖宫产术后都给予早期双下肢气压治疗,观察组术后24 h预防性给予低分子肝素钙治疗,对照组未用药。对比2组产妇静脉血栓发生率,治疗前后凝血功能指标、血液流变学参数和下肢静脉血流速度。结果 观察组产妇剖宫产术后下肢静脉血栓发生率(1.79%)明显低于对照组(6.25%),差异具有统计学意义(P <0.05)。临床治疗前两组D-二聚体水平、纤维蛋白原、部分凝血活酶时间、凝血酶原时间、血小板计数、血浆粘度水平比较,差异无统计学意义(P> 0.05)。术后2组产妇治疗6天后,部分凝血活酶时间、凝血酶原时间无明显变化,且组间比较差异无统计学意义(P> 0.05);观察组D-二聚体水平、纤维蛋白原、血小板记数、血浆粘度降低,而对照组无明显变化,组间比较差异具有统计学意义(P <0.05);2组下肢静脉血流速度升高,组间比较差异具有统计学意义(P <0.05)。结论 剖宫产术后使用低分子肝素钙结合双下肢气压治疗,能够有效改善产妇的凝血功能,加快下肢静脉血流速度,从而降低下肢静脉血栓发生率。
Objective:To investigate the effect of early application of low molecular heparin calcium combined with double lower limb pneumatic therapy on the prevention of lower limb venous thrombosis after cesarean section.Methods:224 women after caesarean section in our hospital from 2018-01 to 2020-01 were selected and randomly divided into 112 cases in the control group and 112 cases in the observation group.Both groups were treated with early bilateral lower limb pneumatic compression therapy,with prophylactic use of low molecular heparin calcium in the observation group 24 hours after surgery,but no medication in the control group.The incidence of venous thrombosis,coagulation index,blood rheology parameters and lower limb venous blood flow velocity before and after treatment were compared between the two groups.Results:The incidence of venous thrombosis in the lower limbs after caesarean section was lower in the observation group(1.79%)than that in the control group(6.25%),and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in D-dimer level,fibrinogen,partial thromboplastin time,prothrombin time,platelet count and plasma viscosity between the two groups(P>0.05).In the observation group,D-dimer level,fibrinogen,platelet count and plasma viscosity decreased while in the control group,there was no significant change and the difference between the groups was statistically significant(P<0.05),and the lower limb venous flow rate increased in both groups and the difference between the groups was statistically significant(P<0.05).Conclusion:The use of low molecular heparin calcium combined with double lower limb pneumatic compression after caesarean section can effectively improve maternal coagulation function and lower limb venous blood flow rate,and reduce the incidence of lower limb venous thrombosis.
作者
张桂果
周瑶
郑莉莉
ZHANG Guiguo;ZHOU Yao;ZHENG Lili(Obstetrics Department,The Second Affiliated Hospital of Shandong First Medical University,Taian 271000,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2023年第5期333-336,共4页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
关键词
剖宫产
静脉血栓
低分子肝素钙
气压治疗
caesarean section
venous thrombosis
low molecular heparin calcium
pneumatic therapy
