【摘要】 目的 分析低分子肝素钠预防性抗凝联合空气波压力在预防血栓高危妊娠孕妇剖宫产术后血栓性事件中的应用价值。方法 将血栓高危妊娠剖宫产产妇随机分为对照组和试验组。对照组产妇术后24 h给予空气波压力干预；试验组在对照组的基础上给予低分子肝素钠2 500 U,皮下注射，每日1次，连续5 d。比较2组产妇术后血栓事件发生情况、围术期凝血功能变化、血液黏度变化，并记录观察期间药物不良反应情况。结果 试验过程无病例脱落，最终试验组和对照组均纳入56例。剖宫产术后15 d内，对照组出现下肢深静脉血栓3例、股静脉血栓3例、小腿肌肉静脉丛血栓2例，试验组出现下肢深静脉血栓2例，试验组产妇术后血栓事件发生率（14.29%）低于对照组（3.57%）,差异有统计学意义（P<0.05）。术后5 d时，试验组和对照组纤维蛋白原（FIB）分别为（4.02±0.51）和（4.36±0.44）g·L^-1,D-二聚体（D-D）分别为（403.36±30.82）和（434.62±27.04）μg·L^-1,血浆黏度（PV）分别为（1.87±0.49）和（2.11±0.54）mPa·s,全血高切黏度（HBV）分别为（4.76±0.53）和（5.04±0.49）mPa·s,凝血酶原时间（PT）分别为（13.27±1.19）和（12.48±1.22）s,活化的部分凝血活酶时间（APTT）分别为（30.41±2.09）和（29.42±2.31）s,凝血酶时间（TT）分别为（16.14±1.29）和（15.58±1.25）s, 2组比较差异均有统计学意义（均P<0.05）。试验组和对照组产妇术后出血和术后下床时间差异均无统计学意义（均P>0.05）。结论 低分子肝素钠防性抗凝联合空气波压力可有效降低血栓高危妊娠剖宫产产妇术后血栓事件发生率，还可改善产妇术后短期内高凝状态。更多还原

【Abstract】 Objective To analyze the application value of low molecular weight heparin（LMWH） sodium for prophylactic anticoagulation combined with air wave pressure in preventing thrombotic events in women with high-risk pregnancy after cesarean section. Methods Women with high-risk pregnancy after cesarean section were randomly divided into control group and treatment group. At 24 h after surgery, the control group was given air wave pressure, while the treatment group was additionally given low molecular weight heparin sodium（2 500 U, ih, qd） for 5 d. The occurrence of postoperative thrombotic events and changes of perioperative coagulation function and blood viscosity were compared between the two groups. The adverse drug reactions during observation period were recorded.Results There was no case lost during the treatment, and there were 56 cases in treatment group and 56 cases in control group. Within15 d after cesarean section, there were 3 cases with deep vein thrombosis, 3 cases with femoral vein thrombosis and 2cases with calf muscular venous thrombosis in control group, while there was 2 cases with deep vein thrombosis in treatment group. The incidence of postoperative thrombotic events in the treatment group was lower than that in the control group（14. 29%vs. 3. 57%,P< 0. 05）. At 24 h and 5 d after surgery, levels of fibrinogen（ FIB） and activated partial thromboplastin time（ APTT） were decreased（P< 0. 05）, while levels ofD-dimer（D-D）,platelets（PLT） and whole blood high blood viscosity（HBV） were increased in both groups（P< 0. 05）. At 5 d after surgery, FIB levels in treatment group and control group were（4. 02 ± 0. 51） and（4. 36 ± 0. 44） g·L^-1,D-D levels were（403. 36 ± 30. 82） and（434. 62 ± 27. 04） μg · L^-1, PV were（1. 87 ± 0. 49） and（2. 11 ± 0. 54）mPa·s, HBV were（4. 76 ± 0. 53） and（5. 04 ± 0. 49） mPa·s, PT were（13. 27 ± 1. 19） and（12. 48 ± 1. 22） s,APTT were（30. 41 ± 2. 09） and（29. 42 ± 2. 31） s, TT were（16. 14 ± 1. 29） and（15. 58 ± 1. 25） s, the difference were all statistically significant（ allP< 0. 05）. The postoperative blood loss and postoperative leaving bed time in treatment group and control group were not statistically significant（P> 0. 05）.Conclusion Low molecular weight heparin sodium for prophylactic anticoagulation combined with air wave pressure can effectively reduce the incidence of thrombotic events and improve short-term hypercoagulable state in women with high-risk pregnancy after cesarean section.更多还原