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目的观察低分子肝素钙注射液对重症监护室患者静脉血栓栓塞症(VTE)的预防作用和安全性。方法重症监护室住院的、超过1项高危静脉血栓栓塞症因素的患者60例,随机分为试验组30例和对照组30例。对照组皮下注射0.9%NaCl 0.3 mL,qd;试验组皮下注射低分子肝素钙注射液0.3 mL,qd,连续给药14 d。观察2组患者治疗前后D-二聚体,血小板,肌酸酐,血红蛋白,凝血酶原时间及药物不良反应发生情况。结果试验组静脉血栓栓塞症(VTE)发生率为3.33%(1/30例),对照组为23.33%(7/30例),差异有统计学意义(P<0.05)。试验组D-二聚体为(2.79±1.36)mg·L~(-1);对照组为(7.86±3.13)mg·L~(-1),差异有统计学意义(P<0.05)。试验组血小板为(153.30±53.60)×10~9/L,肌酸酐为(94.40±16.43)μmol·L~(-1),血红蛋白为(93.83±14.67)g·L-1,凝血酶原时间为(13.99±1.76)s;对照组血小板为(165.40±64.69)×10~9/L,肌酸酐为(94.10±15.25)μmol·L~(-1),血红蛋白为(103.03±12.99)g·L-1,凝血酶原时间为(13.64±1.42)s,差异无统计学意义(P>0.05)。试验组和对照组的严重血小板减少发生率分别为10.00%(3/30例)和6.67%(2/30例),差异无统计学意义(P>0.05)。2组均未发生大出血、气道、消化道、皮肤黏膜及泌尿系统渗血等药物不良反应。结论预防剂量的低分子肝素钙注射液可以减少内科重症监护室患者静脉血栓栓塞症的发生率,且不增加药物不良反应发生率。
Objective To observe the preventive effect and safety of low molecular weight heparin injection on venous thromboembolism (VTE) in intensive care unit. Methods Sixty patients with more than one high-risk venous thromboembolism hospitalized in intensive care unit were randomly divided into experimental group (30 cases) and control group (30 cases). The control group was subcutaneously injected 0.9% NaCl 0.3 mL, qd. The experimental group was subcutaneously injected 0.3 mL of low molecular weight heparin calcium injection qd for 14 days. D-dimer, platelet, creatinine, hemoglobin, prothrombin time and adverse drug reactions were observed in two groups before and after treatment. Results The incidence of venous thromboembolism (VTE) was 3.33% (1/30) in the test group and 23.33% (7/30 cases) in the control group, the difference was statistically significant (P <0.05). The D-dimer in the experimental group was (2.79 ± 1.36) mg · L -1 and in the control group was 7.86 ± 3.13 mg · L -1, the difference was statistically significant (P <0.05). The platelet count of the experimental group was (153.30 ± 53.60) × 10 ~ 9 / L, the creatinine was (94.40 ± 16.43) μmol·L -1 and the hemoglobin was (93.83 ± 14.67) g · L -1 Was (13.99 ± 1.76) s in the control group; (165.40 ± 64.69) × 10-9 / L in the control group, (94.10 ± 15.25) μmol·L -1 creatinine and (103.03 ± 12.99) g · L-1, prothrombin time was (13.64 ± 1.42) s, the difference was not statistically significant (P> 0.05). The incidences of severe thrombocytopenia in trial group and control group were 10.00% (3/30 cases) and 6.67% (2/30 cases) respectively, with no significant difference (P> 0.05). No adverse reactions such as bleeding, airway, digestive tract, mucocutaneous and urinary system oozing occurred in the two groups. Conclusion The preventive dose of low molecular weight heparin injection can reduce the incidence of venous thromboembolism in medical intensive care unit, and does not increase the incidence of adverse drug reactions.