目的 探討華法林鈉片聯(lián)合低分子量肝素鈉注射液治療產(chǎn)后靜脈血栓栓塞癥的臨床療效。方法 選取2010年7月—2015年7月在承德醫(yī)學院附屬醫(yī)院進行診治的產(chǎn)后靜脈血栓栓塞患者67例為研究對象，所有入選產(chǎn)婦根據(jù)治療差異分為對照組（34例）和治療組（33例）。對照組產(chǎn)后12 h皮下注射低分子量肝素鈉注射液，100 IU/kg，2次/d。治療組在對照組的基礎(chǔ)上口服華法林鈉片，首次2.5 mg，1次/d，根據(jù)其結(jié)果調(diào)整華法林用量，當凝血酶原時間的國際標準化比值為2.0~3.0時，停用低分子量肝素鈉注射液。兩組患者均連續(xù)治療3個月。觀察兩組的臨床療效，比較兩組的血管通暢情況和不良事件。結(jié)果 治療后，對照組和治療組的總有效率分別為73.53%、90.91%，兩組比較差異有統(tǒng)計學意義（P < 0.05）。治療后，對照組和治療組的血管通暢率分別為73.53%、84.85%，兩組比較差異有統(tǒng)計學意義（P < 0.05）。對照組和治療組的血栓形成后綜合征發(fā)生率分別為35.29%、12.12%，兩組比較差異有統(tǒng)計學意義（P < 0.05）。結(jié)論 華法林鈉片聯(lián)合低分子量肝素鈉注射液治療產(chǎn)后靜脈血栓栓塞癥具有較好的臨床療效，可增加血管通暢率，安全較好，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection in treatment of postpartum venous thromboembolism. Methods Patients (67 cases) with postpartum venous thromboembolism in the Affiliated Hospital of Chengde Medical University from July 2010 to July 2015 were randomly divided into the control group (34 cases) and the treatment group (33 cases). Patients in the control group were sc administered with Low Molecular Weight Heparin Sodium Injection at postpartum 12 h, 100 IU/kg, twice daily. Patients in the treatment group were po administered with Warfarin Sodium Tablets on the basis of the control group, first dose 2.5 mg, once daily, adjusting the amount of warfarin according to the results, when the international normalized ratio of prothrombin time was 2 to 3, the Low Molecular Weight Heparin Sodium Injection was discontinued.. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and vascular patency and adverse events in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.53% and 90.91%, respectively, and there was difference between two groups (P < 0.05). After treatment, the vascular patency rates in the control and treatment groups were 73.53% and 84.85%, respectively, and there was difference between two groups (P < 0.05). After treatment, the incidence rates of post thrombosis syndrome in the control and treatment groups were 35.29% and 12.12%, respectively, and there was difference between two groups (P < 0.05). Conclusion Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection has clinical curative effect in treatment of postpartum venous thromboembolism, can increase vascular patency, with good safety, which has a certain clinical application value.

承德市科學技術(shù)研究與發(fā)展計劃項目（20157061）