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目的分析儿童肝移植术后应用不同肝素抗凝对肝素诱导的血小板减少症(HIT)的影响,以探讨肝素类抗凝药的安全使用。方法回顾性分析2006年6月至2014年4月重庆医科大学附属儿童医院59例肝移植患儿的临床资料。根据患儿术后HIT的发生情况,分析两种类型肝素对HIT的影响。结果 59例病例中,术后使用普通肝素36例,发生HIT 5例,发生率为13.9%,使用低分子肝素23例,无HIT发生,二者差异有统计学意义(P<0.05);普通肝素组围术期死亡率为19.4%(7/36),低分子肝素组围术期死亡率为8.7%(2/23),二者差异无统计学意义(P>0.05)。结论儿童肝移植术后,使用低分子肝素可有效降低HIT的发生率。
Objective To analyze the effect of different heparin anticoagulation on heparin-induced thrombocytopenia (HIT) after liver transplantation in children so as to explore the safe use of heparin anticoagulants. Methods The clinical data of 59 children with liver transplantation from June 2006 to April 2014 in Children’s Hospital of Chongqing Medical University were retrospectively analyzed. According to the occurrence of postoperative HIT in children, the effects of two types of heparin on HIT were analyzed. Results Among the 59 cases, there were 36 cases of unfractionated heparin after operation and 5 cases of HIT occurred, the incidence rate was 13.9%. There were 23 cases with low molecular weight heparin without HIT, the difference was statistically significant (P <0.05) Perioperative mortality was 19.4% (7/36) in heparin group and 8.7% (2/23) in low molecular weight heparin group. There was no significant difference between the two groups (P> 0.05). Conclusion After liver transplantation in children, the use of low molecular weight heparin can effectively reduce the incidence of HIT.