皮下注射低分子肝素钙预防烧伤植皮后深静脉血栓形成的效果评价

摘要

Objective To evaluate the effect of subcutaneous injection of low molecular heparin calcium in the preven-tion of deep vein thrombosis (DVT) formation after skin-grafting due to burn. Methods From January 2013 to Decem-ber 2014,79 patients with burn needing skin-grafting in our hospital were selected,among them,subcutaneous injection of low molecular heparin calcium to prevent DVT in 41 cases was selected into treatment group.38 patients were pro-vided with basic measures like irradiation by infrared therapy apparatus, hot compress of magnesium sulfate,and activa-tion of muscle tissue were applied after skin-grafting and they were selected into control group.Density of plasma D-dimer (D-dimer),platelet count,survival rate of skin-grafting,wound healing time,number of infectious case,bleeding of tissue and organ,and DVT formation were counted. Results In treatment group,after 3,7,11,and 15 days surgery,the den-sity of plasma D-dimer was lower than that of control group (P<0.05).The rate of thrombosis formation in control group (10.5%) was higher than that in treatment group (0) (P<0.05).There was no statistical difference in the density of D-dimer and platelet count before 1 day surgery,survival rate of skin-grafting,wound healing time,the incidence rate of in-fection and bleeding between two groups (P>0.05). Conclusion Subcutaneous injection of low molecular heparin calci-um has a certain clinical significance on preventing patient’s DVT formation after skin-grafting due to burn.%目的：评估皮下注射低分子肝素钙对预防烧伤植皮后深静脉血栓(DVT)形成的效果。方法选取2013年1月~2014年12月本院收治的79例烧伤后需植皮的患者，其中皮下注射低分子肝素钙预DVT患者41例设为治疗组。植皮术后仅使用红外线治疗仪照射，硫酸镁热敷，活动肌肉组织等基础措施的38例为对照组。统计血浆D-二聚体(D-dimer)浓度、血小板计数、植皮成活率、创面愈合时间、感染病例数、组织器官出血病例数和DVT形成数等指标。结果治疗组术后第3、7、11、15 d的血浆D-dimer浓度均低于对照组(P<0.05)；对照组的血栓形成率为10.5%，明显高于治疗组的0(P<0.05)；两组术前1 d的D-dimer浓度、血小板计数，植皮成活率、创面愈合时间、感染及出血发生率差异无统计学意义(P>0.05)。结论皮下注射低分子肝素钙对预防烧伤植皮术后患者DVT形成有一定的临床意义。