金麗娟

[摘要] 目的 對(duì)婦科手術(shù)后患者通過 G-Caprini（gynecological caprini）血栓風(fēng)險(xiǎn)評(píng)估模型進(jìn)行深靜脈血栓（deep ve-nous thrombosis，DVT）的風(fēng)險(xiǎn)評(píng)估，探討婦科手術(shù)后深靜脈血栓的預(yù)防及治療。 方法 方便選取該院于2017年11月—2018年11月收治的90例患者分為觀察組與對(duì)照組，每組45例，對(duì)照組患者術(shù)后進(jìn)行下肢間歇性氣囊加壓（intermittent pneumatic compression，IPC）預(yù)防深靜脈血栓，觀察組患者進(jìn)行下肢間歇性氣囊加壓+低分子量肝素鈣（low molecular weight heparin，LMWH）預(yù)防深靜脈血栓，檢測兩組患者2、5 d的D-二聚體，術(shù)后5 d對(duì)患者進(jìn)行下肢血管加壓超聲檢測（compression ultrasound，CUS），對(duì)比兩組患者術(shù)后發(fā)生深靜脈血栓的發(fā)生情況。 結(jié)果 觀察組有2例患者出現(xiàn)深靜脈血栓，對(duì)照組有8例患者出現(xiàn)深靜脈血栓，深靜脈血栓發(fā)生率分別為4.44%和17.77%，組間對(duì)比差異統(tǒng)計(jì)學(xué)意義（χ2=4.050 0，P=0.044 1）。手術(shù)后第5天觀察組患者D-二聚體明顯比對(duì)照組要低，組間對(duì)比差異無統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 對(duì)婦科手術(shù)后患者進(jìn)行下肢間歇性氣囊加壓+低分子量肝素鈣預(yù)防深靜脈血栓有著良好的預(yù)防效果，患者D-二聚體數(shù)值能夠?qū)颊叩纳铎o脈血栓的小腸進(jìn)行動(dòng)態(tài)監(jiān)測。

[關(guān)鍵詞] 婦科手術(shù)后;深靜脈血栓;預(yù)防及治療

[中圖分類號(hào)] R713;R543.6? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2019）05（c）-0069-03

[Abstract] Objective To evaluate the risk of deep venous thrombosis （DVT） after gynecologic surgery in patients with gynecologic surgery through G-Caprini （gynecological caprini） thrombosis risk assessment model. Methods 90 patients admitted to our hospital from November 2017 to November 2018 were convenient divided into observation group and control group， 25 cases in each group. The control group underwent intermittent pneumatic compression （intermittent pneumatic compression， IPC） prevention of deep vein thrombosis. Patients in the observation group underwent intermittent balloon compression + low molecular weight heparin （LMWH） to prevent deep vein thrombosis. The D-dimer of 2 and 5 d was detected in the two groups. After 5 d， the patient underwent compression ultrasound （CUS） of lower extremity， and the incidence of deep vein thrombosis occurred in the two groups. Results In the observation group， 2 patients developed deep vein thrombosis. In the control group， 8 patients developed deep vein thrombosis. The incidence of deep vein thrombosis was 4.44% and 17.77%， respectively. The difference between the groups was statistically significant （χ2=4.050 0， P=0.044 1）. The D-dimer of the observation group was significantly lower than that of the control group on the 5th day after surgery. There was statistically significant difference between the two groups （P<0.05）. Conclusion The patients with gynecological surgery have a good preventive effect on intermittent balloon compression + low molecular weight heparin calcium to prevent deep vein thrombosis. The D-dimer value of patients can dynamically monitor the small intestine of patients with deep vein thrombosis.

[Key words] After gynecological surgery; Deep vein thrombosis; Prevention and treatment