低分子肝素钙注射液对重症监护室患者静脉血栓栓塞症的预防作用研究

发布时间：2018-01-19 19:10

本文关键词： 低分子肝素钙注射液静脉血栓栓塞症重症监护室　出处：《中国临床药理学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的观察低分子肝素钙注射液对重症监护室患者静脉血栓栓塞症(VTE)的预防作用和安全性。方法重症监护室住院的、超过1项高危静脉血栓栓塞症因素的患者60例,随机分为试验组30例和对照组30例。对照组皮下注射0.9%NaCl 0.3 mL,qd;试验组皮下注射低分子肝素钙注射液0.3 mL,qd,连续给药14 d。观察2组患者治疗前后D-二聚体,血小板,肌酸酐,血红蛋白,凝血酶原时间及药物不良反应发生情况。结果试验组静脉血栓栓塞症(VTE)发生率为3.33%(1/30例),对照组为23.33%(7/30例),差异有统计学意义(P0.05)。试验组D-二聚体为(2.79±1.36)mg·L~(-1);对照组为(7.86±3.13)mg·L~(-1),差异有统计学意义(P0.05)。试验组血小板为(153.30±53.60)×10~9/L,肌酸酐为(94.40±16.43)μmol·L~(-1),血红蛋白为(93.83±14.67)g·L-1,凝血酶原时间为(13.99±1.76)s;对照组血小板为(165.40±64.69)×10~9/L,肌酸酐为(94.10±15.25)μmol·L~(-1),血红蛋白为(103.03±12.99)g·L-1,凝血酶原时间为(13.64±1.42)s,差异无统计学意义(P0.05)。试验组和对照组的严重血小板减少发生率分别为10.00%(3/30例)和6.67%(2/30例),差异无统计学意义(P0.05)。2组均未发生大出血、气道、消化道、皮肤黏膜及泌尿系统渗血等药物不良反应。结论预防剂量的低分子肝素钙注射液可以减少内科重症监护室患者静脉血栓栓塞症的发生率,且不增加药物不良反应发生率。
[Abstract]:Objective to observe the preventive effect and safety of low molecular weight heparin calcium injection on venous thromboembolism in intensive care unit (ICU). Sixty patients with more than one high risk factor of venous thromboembolism were randomly divided into trial group (n = 30) and control group (n = 30). The experimental group was subcutaneously injected with low molecular weight heparin calcium injection (LMWHC) 0.3 mL QD for 14 days. Before and after treatment, D-dimer, platelet, creatinine and hemoglobin were observed in the two groups. Results the incidence of venous thromboembolism (VTEE) was 3.33 / 1 / 30 in the test group and 23.33 / 7 / 30 in the control group. The difference was statistically significant (P 0.05). The D- dimer of the experimental group was 2.79 卤1.36 mg 路L ~ (-1). The control group was 7.86 卤3.13mg 路L ~ (-1) (P < 0.05), and the platelet count in the test group was 153.30 卤53.60 脳 10 ~ (-1 / L) 脳 10 ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1) 路L ~ (-1). Creatinine was 94.40 卤16.43 渭 mol 路L ~ (-1) and hemoglobin was 93.83 卤14.67 g 路L ~ (-1). Prothrombin time was 13.99 卤1.76 s; In the control group, the platelet count was 165.40 卤64.69) 脳 10 ~ (9 / L), and the creatinine was 94.10 卤15.25 渭 mol 路L ~ (-1) 路L ~ (-1). The hemoglobin and prothrombin time were 103.03 卤12.99 g 路L -1 and 13.64 卤1.42 Ms, respectively. The incidence of severe thrombocytopenia in the test group and the control group was 10.00 and 6.67 / 2 / 30, respectively. There was no significant difference between the two groups (P 0.05). No massive hemorrhage, airway, and digestive tract were found in all the groups. Conclusion low molecular weight heparin calcium injection can reduce the incidence of venous thromboembolism in ICU patients. The incidence of adverse drug reactions was not increased.
【作者单位】：杭州红十字会医院结核重症监护室;
【基金】：浙江省医药卫生科技计划基金资助项目(2014KYA182)
【分类号】：R459.7
【正文快照】： 重症监护室患者因病情危重合并多种危险因素,是静脉血栓栓塞症的高危人群[1],既往已有指南对骨科及妇科恶性肿瘤术后中、高危静脉血栓栓塞症患者给予肝素或低分子肝素进行预防[2]。本研究探讨低分子肝素钙注射液对重症监护室患者静脉血栓栓塞症的预防作用。材料、对象与方法

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