Efficacy and safety of low molecular weight heparin calcium in prevention of deep vein thrombosis after hypertensive intracerebral hemorrhage operation

Qin Zhengdong; Ge Xin

doi:10.3760/cma.j.issn.1673-4777.2018.04.016

Abstract：Objective To observe the efficacy and safety of low molecular weight heparin (LMWH) calcium in prevention of deep vein thrombosis (DVT) after hypertensive intracerebral hemorrhage (HICH) operation.Methods A total of 98 patients with HICH were enrolled from January 2014 to June 2016 in Tengzhou Central People's Hospital of Shandong Province and they were randomly divided into control group and observation group,with 49 cases in each group.Both groups had routine postoperative treatments combined with intermittent pneumatic compression.Patients in observation group had abdominal subcutaneous injection of LMWH calcium for 14 days since the 3rd day after operation.Occurrences of DVT and pulmonary embolism and recurrence of intracerebral hemorrhage were recorded.Changes of platelet count,coagulation function indexes and D-dimer level were analyzed.Results Incidence of lower limb DVT in observation group was significantly lower than that in control group[2.0％ (1/49) vs 22.4％ (11/49)] (x2 =3.209,P =0.002).Incidences of pulmonary embolism and cerebral hemorrhage showed no significant differences between groups(P ＞ 0.05).Platelet count,coagulation function indexes and D-dimer level showed no significant differences between groups before treatment(P ＞ 0.05).Fourteen days after operation,platelet count in observation group was significantly lower,prothrombin time,activated partial thromboplastin time and thrombin time were significantly longer,levels of fibrinogen and D-dimer were significantly lower than those in control group [(251 ± 20) × 109/L vs (261 ± 24) × 109/L,(12.8 ± 0.5) s vs (12.2±0.8)s,(33.7 ±2.4)s vs (31.9 ±2.9)s,(14.2 ±1.0)s vs (13.2 ±0.9)s,(3.0 ±0.3)g/L vs (3.3±0.3)g/L,(0.99±0.24)mg/L vs (1.26±0.28)mg/L](P＜0.05).Conclusion Post-HICH patients have a high risk of DVT;LMWH can reduce the incidence rate of DVT without increasing bleeding risk.