摘要
目的探讨腹腔镜子宫切除术患者使用低分子肝素辅以间歇性空气压力治疗仪按压预防下肢深静脉血栓(DVT)的效果。方法选取2022年5月~2023年12月在永煤集团总医院行腹腔镜子宫切除术后伴有DVT高风险患者122例,按照随机数字表法分为对照组和观察组,各61例,对照组术后给予低分子肝素治疗,观察组给予低分子肝素治疗辅以间歇性空气压力治疗仪按压双下肢。比较两组患者临床疗效、凝血功能变化、术后恢复情况以及血栓弹力图指标变化。结果治疗后,观察组患者血栓发生率明显低于对照组(P<0.05),血清凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)水平明显高于对照组,纤维蛋白原(Fib)、D-二聚体(D-D)水平明显低于对照组(P<0.05),观察组术后下床活动时间、腹痛消失时间以及住院时间均明显低于对照组(P<0.05)。两组患者血栓弹力图指标凝血时间(K)、Angle角(α)无明显差异(P>0.05),观察组的凝血反应时间(R)明显高于对照组,最大振幅(MA)、凝血指数(CI)明显低于对照组(P<0.05)。结论腹腔镜子宫切除术后给予低分子肝素辅以间歇性空气压力治疗仪按压能够预防DVT形成,改善患者血栓弹力图指标水平,可在临床推广。
Objective To investigate the effect of low-molecular-weight heparin(LMWH)combined with intermittent pneumatic compression device(IPC)in preventing the formation of deep vein thrombosis(DVT)in the lower extremities of patients undergoing laparoscopic hysterectomy.Methods A total of 122 patients with high risk of DVT after laparoscopic hysterectomy in Yongmei Group General Hospital from May 2022 to December 2023 were selected and randomly divided into a control group and an observation group,with 61 patients in each group.The control group was treated with LMWH after surgery,while the observation group was treated with LMWH combined with IPC to compress both lower extremities.The clinical efficacy,changes in coagulation function,postoperative recovery,and changes in thrombus elastography indexes were compared between the two groups.Results After treatment,the incidence of thrombosis in the observation group was significantly lower than that in the control group(P<0.05).The serum levels of PT and APTT were significantly higher in the observation group than in the control group,while the levels of Fib and D-D were significantly lower(P<0.05).The time of ambulation,disappearance of abdominal pain,and length of hospital stay were significantly shorter in the observation group than in the control group(P<0.05).There were no significant differences in the thrombus elastography indexes K and Angle between the two groups(P>0.05),but the R was significantly higher and the MA and CI were significantly lower in the observation group than in the control group(P<0.05).Conclusion The combination of LMWH and IPC in patients after laparoscopic hysterectomy can prevent the formation of DVT,improve the thrombus elastography index levels,and can be promoted clinically.
作者
张洁
Zhang Jie(Department of Obstetrics and Gynecology,Yongmei Group General Hospital,Shangqiu 476600,China)
出处
《华北理工大学学报（医学版）》
2024年第4期296-300,共5页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
腹腔镜子宫切除术
低分子肝素
下肢静脉血栓
Laparoscopic hysterectomy
Low-molecular-weight heparin
Deep vein thrombosis of the lower extremities
