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目的研究围术期应用小剂量低分子肝素对阴式子宫切除患者凝血功能的影响。方法选择2009年5月至2013年5月在开封市妇产医院行阴式子宫切除的患者50例,随机分为观察组25例和对照组25例,观察组在围术期皮下注射小剂量低分子肝素,对照组采用常规治疗方法,分别于术前(T1)、术毕(T2)、术后24 h(T3)、术后4 d(T4)抽取静脉血,检测血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、血栓调节蛋白(TM)及D-二聚体(D-D),比较两组PT、APTT、TM和D-D水平。记录并比较两组术中出血量、手术后24 h引流量。结果对照组T2、T3时间点PT、APTT与T1比较缩短(P<0.05);对照组T2、T3时间点TM、D-D高于观察组(P<0.01)。两组术中出血量及术后24 h引流量比较差异均无统计学意义(P>0.05)。结论围术期应用小剂量低分子肝素可以明显改善阴式子宫切除患者的凝血功能。
Objective To study the effect of perioperative low-dose low-molecular-weight heparin on coagulation function in patients with vaginal hysterectomy. Methods Fifty patients with vaginal hysterectomy in Kaifeng Maternity Hospital from May 2009 to May 2013 were randomly divided into observation group (n = 25) and control group (n = 25). The observation group was treated with subcutaneous injection of low dose Low molecular weight heparin and control group were given conventional therapy. Venous blood was drawn before operation (T1), after operation (T2), 24 h (T3) and 4 d after operation (T4) respectively. Plasma prothrombin time (PT), partial thromboplastin time (APTT), thrombomodulin (TM) and D-dimer (DD) were measured. PT, APTT, TM and DD were compared between the two groups. Record and compare the two groups of intraoperative blood loss, drainage volume 24 h after surgery. Results Compared with T1, PT and APTT in control group at T2 and T3 were shortened (P <0.05). TM and D-D in control group at T2 and T3 were higher than those in observation group (P <0.01). There was no significant difference between the two groups in the amount of bleeding and the amount of drainage 24 hours after operation (P> 0.05). Conclusion Perioperative application of low-dose low molecular weight heparin can significantly improve coagulation function in patients with vaginal hysterectomy.