小剂量肝素用于产科失血性休克患者的临床观察  

Low-dose heparin for obstetric clinical observation of uncontrolled hemorrhagic shock patients

作　　者：程良道[1] 宋劼[1] 张冰[1] 陈蒙蒙[1] 周群[1] 王庆明[1] 

机构地区：[1]江西省妇幼保健院麻醉科,南昌330006

出　　处：《江西医药》2014年第3期199-200,共2页Jiangxi Medical Journal

基　　金：江西省卫生厅重大科研资助项目(20104011)

摘　　要：目的探讨剖宫产术中患者急性大量出血时小剂量肝素对于防治休克并发症的临床效果。方法 40例中央性前置胎盘合并胎盘植入患者行择期剖宫产时急性出血量超过2000ml者,随机均分为肝素组和对照组,每组20例。肝素组患者静脉注射肝素500U,根据试管法测凝血时间≤10min者,追加肝素500U;对照组20例不用肝素。所有患者均采用抗休克治疗,成分输血,必要时切除子宫去除病因。观察两组患者术中出血和术后转归。结果肝素组较对照组术中出血(渗血)明显减少;D-二聚体呈下降趋势。对照组5例肾衰,1例死亡。结论小剂量肝素用于产科失血性休克患者有助于减少出血,防治肾衰、DIC等并发症。Objective To study the patients with acute massive hemorrhage in cesarean section with low-dose of heparin for the prevention and treatment of the clinical effect of shock complications. Methods 40 patients with central placenta previa merged placenta increta line marked in acute blood loss of more than 2000ml,were randomly divided into heparin group and the control group,20 cases in each group. Intravenous heparin group patients 500U,blood coagulation time according to the method of tube test 10 min or less,supplemental heparin 500U. The control group 20 cases without heparin. Adopt anti-shock treatment,all patients composition blood transfusion,hysterectomy abandon if necessary in addition to the cause. Observe two groups of patients, intraoperative bleeding and postoperative outcome. Results The heparin group than the control group obviously reduce intraopera-tive hemorrhage （bleeding）;D-dimer was on the decline. Control group 5 cases of renal failure,1 case died. Conclusion Low-dose of heparin for obstetric patients with uncontrolled hemorrhagic shock helps reduce bleeding ,contribute to the prevention and treatment of renal failure,DIC and other complications.

关 键 词：小剂量肝素 防治 休克并发症 前置胎盘 胎盘植入 

分 类 号：R973.1[医药卫生—药品]