目的：探讨低分子肝素对于围生期血液高凝状态的预防效果及使用安全性评估。方法：收集2011年4月-2012年4月本院住院分娩的孕产妇168例，随机编号法分为对照组67例和低分子肝素组101例，对照组仅给予气压治疗，低分子肝素组给予低分子肝素联合气压治疗，观察两组治疗前后凝血功能的改变，同时填写治疗效果调查表，评估孕期使用低分子肝素的安全性及副作用。结果：经阴道分娩及剖宫产的孕妇中，两组患者出血量比较差异无统计学意义（P>0.05）。低分子肝素组的D-二聚体、Fbg含量明显低于对照组，差异均有统计学意义（P<0.05），而两组患者的PT、TT、APTT差异无统计学意义（P>0.05）。低分子肝素组剖宫产共53例，平均手术时间为32.75 min，与对照组的平均时间31.24 min比较差异无统计学意义（P>0.05）。低分子肝素组出现1例注射部位的血肿，1例出现过敏反应，3例出现转氨酶升高。结论：速碧林能有效地降低PLA、D-二聚体的含量或活性，从而降低血栓形成的风险，同时建议常规检测凝血功能。它与普通肝素相比，对于孕妇无明显毒副作用，更适用于孕妇血栓性疾病及DIC的治疗。%Objective:To study the low molecular weight heparin(LMWH)for perinatal blood hypercoagulability prevention effect and assessed the use safety.Method:One hundred and sixty-eight pregnant women were collected from April 2010 to April 2012 in our hospital.They were randomly divided into the control group for 67 cases and the LMWH group for 101 cases.The control group was only given pressure treatment,and the LMWH group was given low molecular weight heparin combined with pneumatic treatment.The changes of coagulation function before and after treatment was observed, significance(P>0.05).Low molecular heparin group D-dimer,Fbg levels was significantly lower than the control group,the difference had statistical significance(P<0.05),and PT,TT and APTT difference of two groups of patients with no statistical significance(P>0.05).A total of 53 cases of cesarean delivery in low molecular heparin group,the average operation time was 32.75 min,compared with control group the average time of 31.24 min has no statistically significant difference(P>0.05).1 case appeared hematomas of the injection site hematomas in low molecular heparin group,1 case of anaphylactic reaction,and 3 cases of transaminase lifts.Conclusion:Fraxiparine can effectively reduce PLA,D-two dimer content or activity,thus reducing the risk of thrombosis,also recommends routine coagulation function test.Compared with the common heparin,no obvious side effect to pregnant women,treatment is more suitable for thrombotic diseases and DIC of pregnant women.
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