目的 评价低分子肝素预防妇科术后深静脉血栓形成的安全性。方法 计算机检索PubMed、Embase、Cochrane Library、中国学术期刊全文数据库（CNKI）、万方数据库、维普数据库（VIP），收集从建库至2017年10月低分子肝素预防妇科术后深静脉血栓形成的随机对照研究（RCT）及队列研究，采用RevMan 5.3软件进行Meta-分析。结果 共纳入9项RCT和3项队列研究。结果显示，试验组（围手术期使用低分子肝素）和对照组（围手术期未使用低分子肝素）在术后输血率、术后盆腔引流量、凝血酶原时间（PT）、血小板计数（PLT）方面无显著性差异。试验组的活化部分凝血活酶时间（APTT）[MD=1.21，95% CI（0.55，1.86），P=0.0003]长于对照组，而D-二聚体值[MD=-0.21，95% CI（-0.37，-0.06），P=0.006]低于对照组。结论 低分子肝素预防妇科术后深静脉血栓形成比较安全，不增加术后输血率，可以改善术后高凝状态。

Objective To evaluate the safety of low molecular weight heparin (LMWH) in the prevention of deep venous thrombosis after gynecologic surgery. Methods Databases including PubMed, Embase, Cochrane Library, CNKI, WanFang and VIP were retrieved and collected randomized controlled trials (RCTs) and cohort studies from the inception to October 2017. RevMan 5.3 software was used for Meta-analysis. Results A Total of 9 RCTs and 3 cohort studies were included. The results showed that no significant differences were found in postoperative transfusion rates, amount of pelvic drainage, PT and PLT between control group (The patients did not use LMWH during the perioperative period) and experimental group (The patients used LMWH during the perioperative period). The APTT[MD=1.21, 95% CI(0.55, 1.86), P=0.000 3] was longer in experimental group than that of control group. However, the D-dimer[MD=-0.21, 95% CI(0.37, -0.06), P=0.006] was lower in experimental group than that of control group. Conclusion It is safe to use LMWH perioperatively in gynecologic surgery. LMWH couldn't increase postoperative transfusion rates, and could improve postoperative hypercoagulability.