妇科盆腔手术后下肢深静脉血栓的预防  

The prophylaxis for lower extremity deep venous thrombosis after gynecological pelvic surgery:a prospective,randomised study

作　　者：张舰[1] 桑翠琴[1] 赵娜[1] 郭淑丽[1] 王淑珍[1] 吴安石[1] 张震宇[1] 

机构地区：[1]首都医科大学附属朝阳医院妇产科,北京100020

出　　处：《现代妇产科进展》2014年第9期695-699,共5页Progress in Obstetrics and Gynecology

基　　金：首都医学发展科研基金资助项目(No:2011-2003-03)

摘　　要：目的:探讨两种机械预防措施对妇科盆腔术后下肢深静脉血栓(DVT)形成中高危患者的影响和作用。方法:前瞻性随机对照研究有血栓中高危险因素的妇科术后患者139例,将患者随机分成2组,分别采用GCS(142例)、GCS+IPC(136例)预防措施。记录患者手术前后血栓相关指标变化、术后下肢血栓、肺栓塞发生率及相关因素。结果:GCS组的DVT发生率11.3%(16/142),肺栓塞发生率8.5%(6/71);GCS+IPC组的DVT发生率4.4%(6/136),肺栓塞发生率1.5%(1/68)。两组的DVT发生率有统计学意义(P<005),GCS+IPC组的肺栓塞发生率低于GCS组,但差异无统计学意义(P>0.05)。两预防组间术后白细胞、血小板、凝血功能及血栓相关指标平均值水平均无明显统计学差异(P>0.05)。结论:GCS、GCS+IPC均能有效预防DVT的发生,GCS+IPC较GCS预防DVT的效果更佳,而且能降低致死性高的PE发生率。Objective：To investigate the effect of lower extremity deep venous thrombo- sis prophylactics by two mechanical preventive methods in DVT high risk patients after gyneco- logical pelvic surgery. Method：This propective randomized study consisted of 139 postoperative patients who were randomly assigned to two groups with moderate-and high-risk of DVT, GCS, GCS＋IPC were used as prophylactics for DVT, and the records of morbidity of DVT, PE and in- dex related thrombosis both pre-operation and post-operation were analyzed. Result：The mor- bidity of DVT in GCS group was 11.3% ,PE was 8.5% ,DVT in GCS＋IPC group was 4.4% and PE was 1.5 %. The morbidity of DVT between the two groups was statistically significant （P 〈005 ）. The morbidity of PE in GCS＋IPC group was lower than that of GCS group. There were no significantly statistical differences between the two groups （ P〉0.05 ）. The records of index： related thrombosis post-operation between the two groups had no significantly statistical differ- ences（ P〉0.05 ）. Conclusion ： Both GCS and GCS＋IPC could take precautions against DVT ef- fectively. The effects of prophylaxis of DVT in GCS＋IPC group was more effective than that in GCS group, and GCS＋IPC also could reduce morbidity of PE with high mortality.

关 键 词：下肢深静脉血栓 妇科盆腔手术 预防和控制 

分 类 号：R713[医药卫生—妇产科学]