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目的探讨尿素激酶联合低分子肝素防治妇科肿瘤并发下肢静脉血栓的临床效果。方法选取2014年1月至2016年12月间湖南省肿瘤医院收治的100例行腹腔镜妇科肿瘤手术患者,采用随机数表法分为观察组与对照组,每组50例。对照组患者采用低分子肝素抗凝针治疗,观察组在对照组基础上加用尿素激酶治疗。比较两组患者治疗前后下肢血流、血清抗凝血因子Xa活性(抗-FXa)、抗凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血清纤维蛋白原及D-二聚体含量变化,患者住院期间并发症及不良反应情况。结果对照组患者住院期间发生下肢静脉血栓1例,观察组患者无;术后治疗10天期间,两组患者均未出现并发症及不良反应。观察组患者下肢周径和下肢血流显著优于对照组,血清纤维蛋白原和D-二聚体含量显著低于对照组,抗-FXa、PT及APTT值显著高于对照组,组间差异均有统计学意义(均P<0.01)。结论小分子肝素和尿素激酶在妇科肿瘤术后下肢静脉血栓防治中联用,疗效显著,安全性高,值得推广。
Objective To investigate the clinical efficacy of urea kinase combined with low molecular weight heparin in preventing and treating gynecological tumor complicated with venous thrombosis of the lower extremities. Methods A total of 100 patients undergoing laparoscopic gynecologic oncology from Hunan Cancer Hospital from January 2014 to December 2016 were selected and randomly divided into observation group and control group with 50 cases in each group. Control group patients treated with low molecular weight heparin anticoagulant needle, the observation group on the basis of the control group plus urea kinase treatment. The blood flow of lower extremities, serum anticoagulant factor Xa activity (anti-FXa), antithrombin time (PT), activated partial thromboplastin time (APTT), serum fibrinogen and D- Dimer content changes, patients during hospitalization complications and adverse reactions. Results In the control group, 1 case of venous thrombosis occurred during hospitalization and none in the observation group. No complication and adverse reactions occurred in both groups after 10 days of operation. The lower limb circumference and lower limb blood flow in the observation group were significantly better than those in the control group, the levels of serum fibrinogen and D-dimer were significantly lower than those in the control group, and the values of anti-FXa, PT and APTT were significantly higher than those in the control group All were statistically significant (P <0.01). Conclusions The combination of small molecule heparin and urease in the prevention and treatment of lower extremity venous thrombosis after gynecologic oncology has significant curative effect, high safety and worthy of promotion.