[关键词]
[摘要]
目的 比较低分子肝素和贝米肝素治疗产后出血所致弥漫性血管内凝血的疗效。方法 选取2014年11月—2017年11月新郑市人民医院妇产科收治的70例产后出血致弥漫性血管内凝血患者为研究对象,按照随机数字表法分为对照组和治疗组,每组各35例。对照组皮下注射8.0 mg贝米肝素钠注射液,3次/d;治疗组皮下注射0.4 mL低分子量肝素钙注射液,1次/d,根据患者凝血状态加以调整。两组患者治疗1周后观察病情。观察两组的临床疗效,比较两组患者治疗前后C反应蛋白(CRP)、D-二聚体(D-D)、活化部位凝血活酶时间(APPT)和凝血酶原时间(PT)的变化情况。结果 治疗后,治疗组总有效率88.57%显著高于对照组的77.14%,两组比较差异有统计学意义(P<0.05)。两组患者治疗后CRP、D-D、APPT、PT水平均显著低于同组治疗前(P<0.05);治疗后,治疗组CRP、D-D、APPT、PT水平低于对照组(P<0.05)。结论 低分子肝素较贝米肝素治疗产后出血所致弥漫性血管内凝血的疗效显著,可有效降低患者血清中的CRP及D-D水平,具有一定的临床推广应用价值。
[Key word]
[Abstract]
Objective To compare the efficacy of low molecular weight heparin and bemiparin heparin in treatment of diffuse intravascular coagulation caused by postpartum hemorrhage. Methods 70 Patients with diffuse intravascular coagulation due to postpartum hemorrhage admitted to the Department of Obstetrics and Gynecology of Xinzheng People's Hospital from November 2014 to November 2017 were selected as the research objects. According to the random number table method, the patients were divided into the control group and the treatment group, 35 cases in each group. The control group was subcutaneously injected with 8.0 mg Bemiparin Sodium Injection for 3 times/day. The treatment group was subcutaneously injected with Low Molecular Weight Heparin Calcium Injection 0.4 mL, once daily. The dosage was adjusted according to the patient's clotting state. Patients in both groups were observed after 1 week of treatment. The clinical efficacy of the two groups was observed, and the changes of C-reactive protein (CRP), D-dimer (D-D), activated site thrombin time (APPT) and prothrombin time (PT) before and after treatment were compared. Results After treatment, the total effective rate of 88.57% in the treatment group was significantly higher than 77.14% in the control group, and the difference between two groups was statistically significant (P<0.05). The levels of CRP, D-D, APPT and PT in both groups after treatment were significantly lower than those before treatment (P<0.05). After treatment, CRP, D-D, APPT and PT levels in the treatment group were lower than those in the control group (P<0.05). Conclusion Low molecular weight heparin has curative effect in treatment of diffuse intravascular coagulation due to postpartum hemorrhage, and can effectively reduce the serum CRP and D-D levels in patients, which has certain clinical application value.
[中图分类号]
R984
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