妇科手术后预防下肢深静脉血栓形成对患者凝血功能的影响The effect of prophylactic for lower extremity deep vein thrombosis on blood clotting of patients after gynecological surgery:a prospective study
杨柏柳;张震宇;郭淑丽;
摘要(Abstract):
目的研究采取下肢间歇性气囊加压(IPC)与低分子肝素(LMWH)等预防措施对妇科盆腔手术后下肢深静脉血栓形成高危患者凝血功能的影响。方法前瞻性随机对照研究96例妇科手术后有下肢深静脉血栓(DVT)危险因素的患者,使用IPC与LMWH预防后,分析血常规、凝血功能、血栓相关指标及血栓发生率的变化。结果应用IPC与LMWH预防后,抗凝血酶-III(AT-III)较术前显著升高(P<0.05),LMWH使术后血小板水平明显下降(P<0.05)。结论预防性使用IPC与LMWH可以改善妇科盆腔手术后患者的凝血功能,降低深静脉血栓的形成率。
关键词(KeyWords): 血栓深静脉形成;妇科外科手术;预防和控制;凝血功能
基金项目(Foundation): 首都医学发展科研基金资助项目(No:2005-1005);; "十五"攻关肺栓塞规范化诊疗方法基金项目(No:2004BA703B07)
作者(Authors): 杨柏柳;张震宇;郭淑丽;
DOI: 10.13283/j.cnki.xdfckjz.2007.04.010
参考文献(References):
- [1]ENOXACAN Study Group.Efficacy and safety of enoxapa-rin versus unfractioned heparin for prevention of deep vein thrombosis in elective cancer surgery:a double-blind ran-domized multicentre trial with veno graphic assessment[J].Br J Surg,1997,84:1099-1103
- [2]王辰,翟振国.肺血栓栓塞症-深静脉血栓形成的预防策略[J].CGP中国全科医学,2005,8:85-87
- [3]刘玉珍,张震宇.妇科手术后下肢深静脉血栓形成的临床研究[J].中华妇产科杂志,2006,41:107-110
- [4]刘玉珍,张震宇,郭淑丽.妇科开腹与腹腔镜手术后下肢深静脉血栓形成的临床分析[J].现代妇产科进展,2006,15:622-623
- [5]Ginzburg E,Cohn SM,Lopez J,et al.Randomized clinical trial of intermittent pneumatic compression and lowmolec-ular weight heparin in trauma[J].Br J Surg,2003,90:1338-1344
- [6]Flam E,Berry S,Coyle A,et al.Blood-flow augmentation of intermittent pneumatic compression systems used for prevention of deep vein thrombosis prior to surgery[J].Am J Surg,1996,171:312-315
- [7]Inada K,Koike S,Skirai N,et al.Effects of intermittent pneumatic leg compression for prevention of postoperative deep venous thrombosis with special reference to fibrino-lytic activity[J].Am J Surg,1988,155:602-605
- [8]张培华,主编.临床血管外科学[M].北京:北京科学出版社,2003:494-495,605