婦科手術后深靜脈血栓的預防及治療

金麗娟

[摘要] 目的 對婦科手術后患者通過 G-Caprini（gynecological caprini）血栓風險評估模型進行深靜脈血栓（deep ve-nous thrombosis，DVT）的風險評估，探討婦科手術后深靜脈血栓的預防及治療。 方法 方便選取該院于2017年11月—2018年11月收治的90例患者分為觀察組與對照組，每組45例，對照組患者術后進行下肢間歇性氣囊加壓（intermittent pneumatic compression，IPC）預防深靜脈血栓，觀察組患者進行下肢間歇性氣囊加壓+低分子量肝素鈣（low molecular weight heparin，LMWH）預防深靜脈血栓，檢測兩組患者2、5 d的D-二聚體，術后5 d對患者進行下肢血管加壓超聲檢測（compression ultrasound，CUS），對比兩組患者術后發生深靜脈血栓的發生情況。 結果 觀察組有2例患者出現深靜脈血栓，對照組有8例患者出現深靜脈血栓，深靜脈血栓發生率分別為4.44%和17.77%，組間對比差異統計學意義（χ2=4.050 0，P=0.044 1）。手術后第5天觀察組患者D-二聚體明顯比對照組要低，組間對比差異無統計學意義（P<0.05）。 結論 對婦科手術后患者進行下肢間歇性氣囊加壓+低分子量肝素鈣預防深靜脈血栓有著良好的預防效果，患者D-二聚體數值能夠對患者的深靜脈血栓的小腸進行動態監測。

[關鍵詞] 婦科手術后;深靜脈血栓;預防及治療

[中圖分類號] R713;R543.6? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）05（c）-0069-03

[Abstract] Objective To evaluate the risk of deep venous thrombosis （DVT） after gynecologic surgery in patients with gynecologic surgery through G-Caprini （gynecological caprini） thrombosis risk assessment model. Methods 90 patients admitted to our hospital from November 2017 to November 2018 were convenient divided into observation group and control group， 25 cases in each group. The control group underwent intermittent pneumatic compression （intermittent pneumatic compression， IPC） prevention of deep vein thrombosis. Patients in the observation group underwent intermittent balloon compression + low molecular weight heparin （LMWH） to prevent deep vein thrombosis. The D-dimer of 2 and 5 d was detected in the two groups. After 5 d， the patient underwent compression ultrasound （CUS） of lower extremity， and the incidence of deep vein thrombosis occurred in the two groups. Results In the observation group， 2 patients developed deep vein thrombosis. In the control group， 8 patients developed deep vein thrombosis. The incidence of deep vein thrombosis was 4.44% and 17.77%， respectively. The difference between the groups was statistically significant （χ2=4.050 0， P=0.044 1）. The D-dimer of the observation group was significantly lower than that of the control group on the 5th day after surgery. There was statistically significant difference between the two groups （P<0.05）. Conclusion The patients with gynecological surgery have a good preventive effect on intermittent balloon compression + low molecular weight heparin calcium to prevent deep vein thrombosis. The D-dimer value of patients can dynamically monitor the small intestine of patients with deep vein thrombosis.

[Key words] After gynecological surgery; Deep vein thrombosis; Prevention and treatment