肝素钠抗凝治疗及孕妇产后出血量临床分析.docVIP

肝素钠抗凝治疗及孕妇产后出血量临床分析[摘要] 目的：探讨用肝素钠抗凝治疗使血液的凝血酶原时间（PT）维持在正常值2.0～2.5倍的孕妇，观察并测量其在分娩过程中及产后24 h内产后出血量的临床分析。方法：我院1996年1月～2008年5月曾行人工心脏瓣膜置换术、需用肝素抗凝治疗的产妇67例为肝素抗凝治疗组，身体健康无内科及产科合并症的产妇70例为对照组。观察其产时及产后24 h总出血量情况。结果：肝素抗凝治疗组与对照组产后出血无显著性差异（P＞0.05）。结论：正确使用肝素抗凝治疗使PT维持在正常值的2.0～2.5倍，不增加产后出血的机会。 [关键词] 肝素钠；产妇；产后出血量 [中图分类号] R984[文献标识码]C [文章编号]1673-7210（2009）05（a）-072－０2 Heparin anticoagulant therapy for pregnant women with postpartum hemorrhage volume of clinical analysis LIAO Dan, LI Fengying, QIU Meizhen (Department of Obstetrics, the People’s Hospital of Gaozhou City, Guangdong Province, Gaozhou 525200, China) [Abstract] Objective: To explore the use of heparin blood anticoagulant therapy to maintain the value of the PT in the 2.0-2.5 times of the normal pregnant women, to observe and measure its birth in the course of 24 hours of post-natal and post-partum hemorrhage volume of clinical analysis. Methods: From January 1996 to May 2008, the hospital visit had an artificial heart valve replacement required anticoagulant heparin in the treatment of 67 cases of maternal for the anticoagulant heparin in the treatment group, good health without free medical and obstetric complications of maternal 70 cases for the control group, When production of its observation and 24 hours post-partum hemorrhage of the total volume of the situation. Results: Anticoagulant heparin in the treatment group and control group, post-partum haemorrhage was no significant difference(P＞0.05).Conclusion: The proper use of the anticoagulant heparin therapy so that the PT in the maintenance of 2.0-2.5 times of the normal value, won’t increasing the chance of postpartum hemorrhage. [Key words] Sodium heparin; Pregnant women; The amount of postpartum bleeding 弥漫性血管内凝血（DIC）产后大出血是致使孕产妇死亡的主要原因之一。在DIC发生的早期(血液高凝期)，及时抗凝治疗至关重要。肝素能有效地阻断DIC的发生过程[1]。但由于肝素钠为抗凝剂，具有抗凝血作用。而产科DIC的病情发展是一个急性过程，且有创面(胎盘剥离面，手术创面等)，致使部分医务人员在妊娠晚期及分娩时担心加重产后出血的发生而未能及时应用肝素，故不能有效地阻止DIC的发展。其实，产科DIC若能及时去除病因、及时抗凝治疗，此类DIC仍属可控型的。肝素用量也只需小剂量，短疗程就能