CAJ | 학술논문

目的：评价高血压脑出血术后使用低分子肝素预防下肢深静脉血栓形成的效果。方法选择符合条件的82例高血压脑出血术后患者分为预防组和对照组。预防组42例，术后第3天预防性皮下注射低分子肝素钙，1次／d，连续使用14 d，同时每日行间隙气压治疗。对照组40例，仅行间隙气压治疗，未行抗凝治疗。术前2组均行血浆D-二聚体检测，术后7、14、21 d行D-二聚体检测及双下肢静脉超声检查。结果预防组发生下肢深静脉血栓1例（2．38％），颅内出血1例（2．38％）。对照组发生下肢深静脉血栓9例（22．50％），肺栓塞1例（2．50％），颅内出血1例（2．50％）。两组间的再出血及肺栓塞发生率差异无统计学意义，而下肢深静脉血栓形成差异有统计学意义（ P＜0．05）。两组间血浆D-二聚体对比，术前、术后21 d差异无统计学意义，术后7 d、14 d差异有统计学意义（P＜0．05）。结论高血压脑出血术后患者使用小剂量低分子肝素预防下肢深静脉血栓形成安全有效，应积极推广。
목적：평개고혈압뇌출혈술후사용저분자간소예방하지심정맥혈전형성적효과。방법선택부합조건적82례고혈압뇌출혈술후환자분위예방조화대조조。예방조42례，술후제3천예방성피하주사저분자간소개，1차／d，련속사용14 d，동시매일행간극기압치료。대조조40례，부행간극기압치료，미행항응치료。술전2조균행혈장D-이취체검측，술후7、14、21 d행D-이취체검측급쌍하지정맥초성검사。결과예방조발생하지심정맥혈전1례（2．38％），로내출혈1례（2．38％）。대조조발생하지심정맥혈전9례（22．50％），폐전새1례（2．50％），로내출혈1례（2．50％）。량조간적재출혈급폐전새발생솔차이무통계학의의，이하지심정맥혈전형성차이유통계학의의（ P＜0．05）。량조간혈장D-이취체대비，술전、술후21 d차이무통계학의의，술후7 d、14 d차이유통계학의의（P＜0．05）。결론고혈압뇌출혈술후환자사용소제량저분자간소예방하지심정맥혈전형성안전유효，응적겁추엄。
Objective To evaluate the outcome of low molecular weight heparin ( LMWH) for the prevention of lower extremi-ty deep vein thromboembolism ( LDVT) in patients with hypertensive intracerebral hemorrhage after operation .Methods 82 patients with hypertensive intracerebral hemorrhage after operation were divided into two groups :prothylactic group (n=42) and control group (n=40).The patients in prothylactic group were injected hypodermically with LMWH from day 3 to day 14 after operation and treated with intermittent pneumatic compression from 1 to 21 days continuously .Whereas the patients in control group were treated only by in-termittent pneumatic compression .The plasma D-dimer ( D-D) was measured in all patients before operation and was determined at day 7, 14, 21 after operation.The deep veins of lower limbs in all patients were examined with colour Doppler at day 7, 14, 21 after oper-ation to observe venous thromboembolism .Results Only one case of deep vein thrombosis in prothylactic group (2.38%), and one cerebral hemorrhage(2.38%)recurred.In control group, deep vein thrombosis was found in 9 cases(22.50%), and one cerebral hemorrhage(2.50%) recurred, and one pulmonary embolism(2.50%)was found.The DVT incidence between two groups was signifi-cantly different(P<0.05), but the PTE incidence was not significantly different .D-D content at days 7, 14 after operation in control group was significantly higher than that in prophylactic group (P<0.05), but the D-D level had no significant difference before opera-tion and at day 21 after operation between the two groups .Conclusions LMWH is safe and effective for the prevention of LDVT in pa-tients after hypertensive intracerebral hemorrhage operation .