低分子肝素钙联合按摩预防妇科肿瘤术后下肢静脉栓塞的研究

摘要

Objective:To explore the effect of Low Molecular Weight Heparin Calcium combined with massage on the prevention of lower extremity venous thrombosis after gynecological tumor operation.Method:180 cases from the gynecology hospital treated by uterine fibroids after gynecologic abdominal operation,were randomly divided into two groups,90 patients in control group,treated with bed rest,raising the affected limb treatment,6 hours after the operation began to massage,2 times a day,each time for 10 minutes;90 cases in experimental group,on the basis of the conventional therapy and massage,on the first morning after operation to the subcutaneous injection of Low Molecular Heparin Calcium 4000 IU,1 times a day,for 5 consecutive days.After the end of treatment,before and after treatment in patients with platelet count(PLT),hemoglobin(Hb),fibrinogen(FIB),hematocrit(HCT),index of Hematology,and color Doppler ultrasound index were compared.Result:After treatment,compared with control group,the experimental group PLT,Hb increased,the differences were statistically significant(P<0.05);the experimental group FIB,HCT decreased,the differences were statistically significant(P<0.05);the incidence of venous thrombosis,the experimental group(5.5%) was significantly lower than that of control group(10.0%),the difference was statistically significant(P<0.05);the two groups after treatment the blood vessel diameter,blood flow velocity were improved obviously,the differences were statistically significant(P<0.05);after treatment compared with the control group,the blood vessel diameter was decreased more,blood flow velocity was increased significantly in the experimental group,the differences were statistically significant(P<0.05).Conclusion:Low Molecular Heparin Calcium combine with massage in gynecological tumor surgery is exact and significant effect of lower limb venous thrombosis prevention,worthy of further promotion in clinical nursing work.%目的：研究低分子肝素钙联合按摩对妇科肿瘤术后下肢静脉栓塞的预防效果。方法：选取笔者所在医院妇科收治的因妇科肿瘤行妇科肿瘤手术术后患者180例，随机分为两组，其中对照组90例，予卧床、抬高患肢常规治疗，术后6 h开始进行按摩，2次/d，每次10 min；试验组90例，在常规治疗和按摩的基础上，于术后第1天予脐周皮下注射低分子肝素钙4000 IU，1次/d，连续5 d。治疗结束后，对比治疗前后患者血小板计数(PLT)、血红蛋白(Hb)、纤维蛋白原(FIB)、红细胞压积(HCT)等血液学指标，以及彩色多普勒超声指标。结果：治疗后，与对照组比较，试验组PLT、Hb明显高，差异有统计学意义(P<0.05)；试验组FIB、HCT明显低，差异有统计学意义(P<0.05)；静脉血栓发生率，试验组(5.5%)明显低于对照组(10.0%)，差异有统计学意义(P<0.05)；治疗后两组血管内径、血流速度均明显改善，差异有统计学意义(P<0.05)；治疗后与对照组比较，试验组血管内径明显减小，血流速度明显加快，差异有统计学意义(P<0.05)。结论：低分子肝素钙联合按摩对妇科肿瘤术后下肢静脉栓塞的预防效果确切而且显著，值得进一步推广到临床护理工作中。