目的 探讨华法林钠片联合低分子量肝素钠注射液治疗产后静脉血栓栓塞症的临床疗效。方法 选取2010年7月—2015年7月在承德医学院附属医院进行诊治的产后静脉血栓栓塞患者67例为研究对象，所有入选产妇根据治疗差异分为对照组（34例）和治疗组（33例）。对照组产后12 h皮下注射低分子量肝素钠注射液，100 IU/kg，2次/d。治疗组在对照组的基础上口服华法林钠片，首次2.5 mg，1次/d，根据其结果调整华法林用量，当凝血酶原时间的国际标准化比值为2.0~3.0时，停用低分子量肝素钠注射液。两组患者均连续治疗3个月。观察两组的临床疗效，比较两组的血管通畅情况和不良事件。结果 治疗后，对照组和治疗组的总有效率分别为73.53%、90.91%，两组比较差异有统计学意义（P < 0.05）。治疗后，对照组和治疗组的血管通畅率分别为73.53%、84.85%，两组比较差异有统计学意义（P < 0.05）。对照组和治疗组的血栓形成后综合征发生率分别为35.29%、12.12%，两组比较差异有统计学意义（P < 0.05）。结论 华法林钠片联合低分子量肝素钠注射液治疗产后静脉血栓栓塞症具有较好的临床疗效，可增加血管通畅率，安全较好，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection in treatment of postpartum venous thromboembolism. Methods Patients (67 cases) with postpartum venous thromboembolism in the Affiliated Hospital of Chengde Medical University from July 2010 to July 2015 were randomly divided into the control group (34 cases) and the treatment group (33 cases). Patients in the control group were sc administered with Low Molecular Weight Heparin Sodium Injection at postpartum 12 h, 100 IU/kg, twice daily. Patients in the treatment group were po administered with Warfarin Sodium Tablets on the basis of the control group, first dose 2.5 mg, once daily, adjusting the amount of warfarin according to the results, when the international normalized ratio of prothrombin time was 2 to 3, the Low Molecular Weight Heparin Sodium Injection was discontinued.. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and vascular patency and adverse events in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.53% and 90.91%, respectively, and there was difference between two groups (P < 0.05). After treatment, the vascular patency rates in the control and treatment groups were 73.53% and 84.85%, respectively, and there was difference between two groups (P < 0.05). After treatment, the incidence rates of post thrombosis syndrome in the control and treatment groups were 35.29% and 12.12%, respectively, and there was difference between two groups (P < 0.05). Conclusion Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection has clinical curative effect in treatment of postpartum venous thromboembolism, can increase vascular patency, with good safety, which has a certain clinical application value.

承德市科学技术研究与发展计划项目（20157061）