皮下注射低分子肝素钙对烧伤植皮后深静脉血栓形成、创面愈合及感染率的影响  

Effects of subcutaneous injection of low molecular weight heparin calcium on deep venous thrombosis, wound healing and infection rate after skin grafting

作　　者：范宝玉 王娟 赵海磊 

机构地区：[1]北京朝阳急诊抢救中心烧伤整形科,北京100122

出　　处：《感染．炎症．修复》2017年第3期141-144,共4页Infection Inflammation Repair

摘　　要：目的:分析皮下注射低分子肝素钙对烧伤植皮后深静脉血栓、创面愈合及感染率的影响。方法:将我院2015年2月-2017年2月收治的200例烧伤需要植皮的患者随机分为观察组(基础治疗基础上加用皮下注射低分子肝素钙治疗,术前1 d~术后3 d 2 800 IU/d,术后4~7 d 4 800 IU/d)和对照组(仅采用红外线理疗仪照射、热敷、肌肉按摩等基础治疗),每组100例。观察两组患者烧伤植皮后3、7、11 d D-二聚体、血小板变化,创面愈合情况,以及深静脉血栓、感染等并发症发生情况。结果:观察组术后第3、7、11天的血浆D-二聚体浓度、血小板数量均明显低于对照组(P<0.05),观察组DVT发生率为0,明显低于对照组的6.0%(6例,P<0.05);观察组术后创面愈合时间与对照组比较差异无显著性,而观察组感染率为2.0%,明显低于对照组的10.0%(P<0.05)。结论:皮下注射低分子肝素钙,可以有效预防烧伤植皮患者深静脉血栓形成,并且降低感染率。Objective： To evaluate the effect of subcutaneous injection of low molecular weight heparin calcium on deep vein thrombosis （DVT） formation, wound healing and infection rate after skin-grafting in patients with burn. Methods： Two hundred patients with burn requiring skin grafting admitted to the Beijing Chaoyang Emergency Center from Feb. 2015 to Feb. 2017 were involved in present study and randomly divided into observation group and control group （100 each）. Patients in observation group received basic treatment and subcutaneous injection of low molecular heparin calcium （2800 IU/d from 1-day preoperation to 3-day postoperation, and then 4800 IU/d from 4-day to 7-day postoperation）, while patients in control group received basic treatment only （such as infrared physiotherapy irradiation, hot compress with magnesium sulfate and muscle massage）. The changes of the contents of plasma D-dimer, platelet count, as well as wound healing rate, DVT formation and infective rate were observed and compared between the two groups on the day 3, 7 and 11 postoperation. Results： The plasma D-dimer and platelet counts were markedly lower on the 3rd, 7th and 11th day after skin grafting in observation group than in control group （P〈0.05）. The incidence of DVT was obviously higher in control group （6.0%） than in observation group （0, P〈0.05）. The infection rate was significantly lower in observation group （2.0%） than in control group （10.0%, P〈0.05）, but no statistical difference existed between the two groups in wound healing time （P〉0.05）. Conclusions： Subcutaneous injection of low molecular weight heparin calcium can effectually prevent DVT from formation in burned patients and reduce infection rate after skin-grafting.

关 键 词：低分子肝素钙 烧伤 植皮 深静脉血栓 创面愈合 感染率 

分 类 号：R543.6[医药卫生—心血管疾病]