低分子肝素联合弹力袜防治围生期血栓性疾病及其对凝血功能的影响分析
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摘要
目的:探究低分子肝素联合弹力袜防治围生期血栓性疾病及其对患者凝血功能的影响。方法:选取2012年4月-2017年4月来本院产科备产的足月产妇140例作为研究对象,按照随机数字表法将其分为对照组和观察组,各70例。对照组给予常规围生期治疗与弹力袜防治干预,观察组在对照组的基础上给予小剂量低分子肝素抗凝防治干预,比较两组干预前后各项凝血功能指标、围生期血栓性疾病与不良反应发生情况。结果:两组产妇干预前后PLT、TT、PT以及APTT指标水平比较,差异均无统计学意义(P>0.05)。对照组围生期血栓性疾病发生率为14.29%(10/70)明显高于观察组的1.43%(1/70),差异有统计学意义(P<0.05)。干预期间两组均未见明显不良反应。结论:低分子肝素联合弹力袜可有效防治围生期血栓性疾病,对产妇凝血功能影响较少,且不增加不良反应发生风险。
Objective:To investigate the effect of Low Molecular Weight Heparin combined with elastic socks on the prevention and treatment of perinatal thrombotic disease and its influence on coagulation function of patients.Method:A total of 140 pregnant women with full-term delivery in obstetrical department of our hospital from April 2012 to April 2017 were selected as the study subjects.According to the random number table method,they were divided into control group and observation group,70 cases in each group.The control group was given routine perinatal treatment and elastic socks prevention and treatment intervention,the observation group was given a low-dose Low Molecular Weight Heparin anticoagulant prevention and treatment intervention on the basis of the control group.The coagulation function indexes,perinatal thrombotic diseases and adverse reactions were compared between the two groups before and after intervention.Result:There were no significant differences in the levels of PLT,TT,PT and APTT indexes between the two groups before and after intervention(P>0.05).The incidence of perinatal thrombotic diseases in the control group was 14.29%(10/70),which was significantly higher than 1.43%(1/70) in the observation group,the difference was statistically significant(P<0.05).No significant adverse reactions were observed in two groups during intervention period.Conclusion:Low Molecular Weight Heparin combined with elastic socks can effectively prevent and treat perinatal thrombotic diseases,it has less effect on coagulation function of parturient and does not increase the risk of adverse reactions.
Objective:To investigate the effect of Low Molecular Weight Heparin combined with elastic socks on the prevention and treatment of perinatal thrombotic disease and its influence on coagulation function of patients.Method:A total of 140 pregnant women with full-term delivery in obstetrical department of our hospital from April 2012 to April 2017 were selected as the study subjects.According to the random number table method,they were divided into control group and observation group,70 cases in each group.The control group was given routine perinatal treatment and elastic socks prevention and treatment intervention,the observation group was given a low-dose Low Molecular Weight Heparin anticoagulant prevention and treatment intervention on the basis of the control group.The coagulation function indexes,perinatal thrombotic diseases and adverse reactions were compared between the two groups before and after intervention.Result:There were no significant differences in the levels of PLT,TT,PT and APTT indexes between the two groups before and after intervention(P>0.05).The incidence of perinatal thrombotic diseases in the control group was 14.29%(10/70),which was significantly higher than 1.43%(1/70) in the observation group,the difference was statistically significant(P<0.05).No significant adverse reactions were observed in two groups during intervention period.Conclusion:Low Molecular Weight Heparin combined with elastic socks can effectively prevent and treat perinatal thrombotic diseases,it has less effect on coagulation function of parturient and does not increase the risk of adverse reactions.
引文
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[19]王天琪,杨秋荣,陈黎敏.医用弹力袜预防下肢深静脉血栓的研究进展[J].现代中西医结合杂志,2017,26(22):2503-2506.
[20]张力敏.用低分子肝素钙预防腹腔镜下子宫切除术后深静脉血栓形成的效果探析[J].当代医药论丛,2017,15(22):14-16.
[2]Hara N,Miyamoto T,Yamaguchi J,et al.Treatment outcomes of anticoagulant therapy and temporary inferior vena cava filter implantation for pregnancy complicated by venous thrombosis[J].Ann Vasc Dis,2018,11(1):106-111.
[3]Hunt B J,Parmar K,Horspool K,et al.The Di PEP(diagnosis of PE in pregnancy)biomarker study:an observational cohort study augmented with additional cases to determine the diagnostic utility of biomarkers for suspected venous thromboembolism during pregnancy and puerperium[J].Br J Haematol,2018,180(5):694-704.
[4]Goodacre S,Hunt B,Parmar K,et al.19 accuracy of biomarkers for venous thromboembolism in pregnancy:the diagnosis of pulmonary embolism in pregnancy(Di PEP)biomarker study[J].Emerg Med J,2017,34(12):874-875.
[5]Malinowski A K,Bomba-OpońD,Parrish J,et al.Venous thromboembolism in obese pregnant women:approach to diagnosis and management[J].Ginekol Pol,2017,88(8):453-459.
[6]Zoubian A,Bertoletti L,FrappéP.After deep vein thrombosis,which patients refer to vascular specialist for anticoagulant with drawal?A Delphi study results between general practitioners and vascular specialists[J].Presse Med,2017,46(5):e77-e83.
[7]张雯瑶.临床护理路径在围生期栓塞性疾病健康教育中的应用[J].中国基层医药,2014,21(12):1900-1901.
[8]王月姣.妊娠合并静脉血栓栓塞性疾病临床研究[J].中国妇幼保健,2014,29(13):1994-1996.
[9]徐昳.早期体位活动干预预防妊娠期高血压产妇并发下肢深静脉血栓的作用[J].护士进修杂志,2014,29(21):2011-2013.
[10]贾佳,杨巧妮,赵子房.晚期妊娠合并重度子痫前期患者血栓弹力图特点分析[J].中国医科大学学报,2016,45(12):1105-1109.
[11]宋鸿碧,雷后康.血栓弹力图在妊娠合并血小板减少症患者中的应用效果[J].中国医药导报,2015,12(32):83-86.
[12]温勇,刘春源,邢青青.妊娠及产褥期妇女并发下肢深静脉血栓溶栓治疗的临床疗效观察[J].中国妇产科临床杂志,2017,18(5):419-421.
[13]邓宇芳,曾慧琳.联合检测DD、Hcy在鉴别妊娠晚期下肢静脉血栓中的应用[J].临床医学工程,2018,25(2):155-156.
[14]李志萍,汤广恩,黄楷,等.早期弹力袜对易栓症患者异位妊娠腔镜术后下肢深静脉血栓形成的防治作用[J].岭南现代临床外科,2016,16(4):493-496.
[15]马传侠.弹力袜用于妇科术后预防下肢深静脉栓塞的临床观察[J].当代护士(下旬刊),2017(5):78-79.
[16]李娟,史玉琴,刘冬梅.加压弹力袜联合空气波压力治疗仪预防重度子痫前期下肢深静脉血栓疗效观察[J].卫生职业教育,2014,32(23):151-152.
[17]周梅.医用弹力袜在下肢深静脉血栓患者应用中的护理体会[J].今日健康,2015,14(8):187.
[18]刘未群.抗凝治疗联合弹力袜预防妇科术后深静脉血栓形成的临床应用[J].中国社区医师,2017,33(32):65-66.
[19]王天琪,杨秋荣,陈黎敏.医用弹力袜预防下肢深静脉血栓的研究进展[J].现代中西医结合杂志,2017,26(22):2503-2506.
[20]张力敏.用低分子肝素钙预防腹腔镜下子宫切除术后深静脉血栓形成的效果探析[J].当代医药论丛,2017,15(22):14-16.