气压治疗仪联合那屈肝素预防剖宫产术后下肢静脉栓塞的临床研究

摘要 目的：探究气压治疗仪联合那屈肝素预防剖宫产术后下肢静脉栓塞（DVT）的临床效果。方法：选取2021年1月～2022年8月长沙市妇幼保健院收治的172例剖宫产孕妇，以随机数字表法按1:1比例分为联合组、常规组，各86例。常规组采用那屈肝素预治疗，联合组采用气压治疗仪联合那屈肝素治疗。比较两组DVT发生率；术前、术后5 d凝血功能指标凝血酶时间（TT）、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）]、血液流变学指标全血高切黏度、血浆黏度、全血低切黏度]；术前、术后1 d、5 d大小腿腿围；术前、术后1 d、3 d、5 d疼痛视觉模拟量表（VAS）评分。结果：联合组DVT发生率3.49%较常规组11.63%低（P＜0.05）；术后5 d联合组PT、APTT、TT较常规组高，FIB较常规组低（P＜0.05）；术后5 d联合组全血高切黏度、血浆黏度、全血低切黏度较常规组低（P＜0.05）；术后1 d、5 d联合组大小腿腿围较常规组低（P＜0.05）；术后1 d、3 d、5 d联合组VAS评分较常规组低（P＜0.05）。结论：气压治疗仪联合那屈肝素能有效改善剖宫产产妇术后凝血功能及血液流变学，缓解下肢肿胀，减轻术后疼痛，减少DVT的发生。

Clinical Study on the Prevention of Lower Deep Vein Thrombosis after Cesarean Section by Pneumatic Therapeutic Apparatus Combined with Nadroparin

ABSTRACT Objective: To investigate the clinical effect of pneumatic therapeutic apparatus combined with nadroparin in the prevention of lower deep vein thrombosis (DVT) after cesarean section. Methods: 172 cases of cesarean section pregnant women in Changsha Maternity and Child Health Hospital from January 2021 to August 2022 were selected and randomly divided into the combination group and the conventional group with a ratio of 1:1,86 cases each. The conventional group was pretreated with nadroparin,and the combination group was treated with pneumatic therapeutic apparatus and nadroparin.The incidence of DVT was compared between the two groups; Coagulation function indexthrombin time (TT), fibrinogen (FIB), activated partial thromboplastin time (APTT), prothrombin time (PT)], hemorheology indexwhole blood high shear viscosity, plasma viscosity, whole blood low shear viscosity] before and 5 d after operation; leg circumference of upper and lower legs before operation,1 d and 5 d after operation; The visual analogue scale (VAS) scores of pain before and 1d, 3d and 5 d after surgery. Results: The incidence of DVT in the combination group was 3.49% lower than that 11.63% in the conventional group(P<0.05); The PT, APTT and TT in the combination group were higher than those in the conventional group 5d after operation, and the FIB was lower than that in the conventional group (P<0.05). The whole blood high shear viscosity, plasma viscosity and whole blood low shear viscosity in the combination group were lower than those in the conventional group 5 d after operation(P<0.05). The upper and lower leg circumference of the combination group was lower than that of the conventional group on the 1 d and 5 d after operation(P<0.05). The VAS score of the combination group on the 1 d, 3 d and 5d after operation was lower than that of the conventional group (P<0.05). Conclusion: The combination of pneumatic therapeutic apparatus combined with nadroparin can effectively improve the blood coagulation function and hemorheology of cesarean section women, relieve lower limb swelling, relieve postoperative pain, and reduce the occurrence of DVT.