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目的:研究分析低分子肝素钙(LMWH)改善妊娠晚期血钙、纤维蛋白(FIB)、D-二聚体水平与产后出血的关系。方法:对血FIB>5.0 g/L、D-二聚体>3.0 mg/L有产科高危因素患者30例分为两组:治疗组30例应用LMWH 0.4 ml腹壁皮下注射,每天1次,连续6天,1周复查血FIB、D-二聚体、钙离子水平;另1组30例为未治疗组,FIB>5.0 g/L、D-二聚体>3.0 mg/L。结果:妊娠晚期血钙较未孕妇女低,FIB、D-二聚体水平升高,差异有统计学意义(P<0.05);有产科并发症患者应用LMWH后血钙上升,FIB、D-二聚体水平明显下降(P<0.01),产后出血量明显减低,产后出血及难治性产后出血发生率明显下降,与未用药比差异有统计学意义(P<0.05)。结论:LMWH可使妊娠晚期钙水平升高,FIB、D-二聚体水平降低,减少产后出血发生率,预防难治性产后出血发生,值得临床推广应用。
OBJECTIVE: To study the relationship between low molecular weight heparin (LMWH) and late pregnancy to improve blood calcium, fibrin (FIB), D-dimer level and postpartum hemorrhage. Methods: Thirty patients with obstetric risk factors of FIB> 5.0 g / L and D-dimer> 3.0 mg / L were divided into two groups: 30 cases in the treatment group were injected subcutaneously with 0.4 ml LMWH abdominal wall once per day Six days and one week, blood FIB, D-dimer and calcium levels were examined. In the other group, 30 cases were untreated group, FIB> 5.0 g / L and D-dimer> 3.0 mg / L. Results: The level of FIB and D-dimer in the third trimester of pregnant women was lower than that of the non-pregnant women, the difference was statistically significant (P <0.05) Dimer level was significantly decreased (P <0.01), postpartum hemorrhage was significantly reduced, postpartum hemorrhage and refractory postpartum hemorrhage was significantly decreased, with no significant difference (P <0.05). Conclusion: LMWH can increase the levels of calcium in late pregnancy, reduce the levels of FIB and D-dimer, reduce the incidence of postpartum hemorrhage and prevent the occurrence of refractory postpartum hemorrhage. It is worthy of clinical application.