妇科手术后深静脉血栓的预防及治疗

金丽娟

[摘要] 目的 對妇科手术后患者通过 G-Caprini（gynecological caprini）血栓风险评估模型进行深静脉血栓（deep ve-nous thrombosis，DVT）的风险评估，探讨妇科手术后深静脉血栓的预防及治疗。 方法 方便选取该院于2017年11月—2018年11月收治的90例患者分为观察组与对照组，每组45例，对照组患者术后进行下肢间歇性气囊加压（intermittent pneumatic compression，IPC）预防深静脉血栓，观察组患者进行下肢间歇性气囊加压+低分子量肝素钙（low molecular weight heparin，LMWH）预防深静脉血栓，检测两组患者2、5 d的D-二聚体，术后5 d对患者进行下肢血管加压超声检测（compression ultrasound，CUS），对比两组患者术后发生深静脉血栓的发生情况。 结果 观察组有2例患者出现深静脉血栓，对照组有8例患者出现深静脉血栓，深静脉血栓发生率分别为4.44%和17.77%，组间对比差异统计学意义（χ2=4.050 0，P=0.044 1）。手术后第5天观察组患者D-二聚体明显比对照组要低，组间对比差异无统计学意义（P<0.05）。 结论 对妇科手术后患者进行下肢间歇性气囊加压+低分子量肝素钙预防深静脉血栓有着良好的预防效果，患者D-二聚体数值能够对患者的深静脉血栓的小肠进行动态监测。

[关键词] 妇科手术后;深静脉血栓;预防及治疗

[中图分类号] R713;R543.6          [文献标识码] A          [文章编号] 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