周礼志+吴耀强+萧瑞宜

[摘要] 目的 探讨低分子肝素钙在游离皮瓣移植术中应用临床疗效和安全性。 方法 选取2016年2月～2017年2月我院行游离皮瓣移植术患者54例随机分为低钙组（术后给予低分子肝素钙，27例）和肝素钠组（术后给予肝素钠，27例），比较两组患者临床疗效及血管危象、药物不良反应发生情况。 结果 低钙组患者治疗效果显著于肝素钠组（96.30% vs. 70.37%，P<0.05 ）。低钙组患者血管危象、出血倾向、腹痛腹胀、头痛发生率显著低于肝素钠组（22.22% vs. 59.26%，3.70% vs. 22.22%，7.41% vs. 40.74%，7.41% vs. 37.04%，P<0.05）。 结论 低分子肝素钙在游离皮瓣移植术中应用能协助提高皮瓣存活率，提高临床疗效，降低药物不良反應，具有较高临床疗效和用药安全性。

[关键词] 游离皮瓣移植术；低分子肝素钙；血管危象；疗效

[中图分类号] R622.1 [文献标识码] A [文章编号] 2095-0616（2017）13-56-03

[Abstract] Objective To investigate the clinical efficacy and safety of low molecular weight heparin calcium in free flap transplantation. Methods 54 patients with Free flap transplantation ，who were in our hospital from February 2016 to February 2017， were selected and randomly divided to low calcium group（27 cases）and heparin sodium group（27 cases）.The low calcium group was given low-molecular-weight heparin calcium postoperative，and heparin sodium group was given administration of heparin sodium postoperative.The clinical efficacy，vascular crisis，and adverse drug reactions occur were compared between two groups. Results The treatment effect of low calcium group was significantly higher than that of heparin group（96.30% vs. 70.37%，P<0.05）.The incidence of vascular crisis，bleeding tendency，abdominal pain，abdominal distension and headache in the low calcium group were significantly lower than that in the heparin group（22.22% vs. 59.26%，3.70% vs. 22.22%，7.41% vs. 40.74%，7.41% vs. 37.04%，P<0.05）. Conclusion Low molecular weight heparin calcium in free flap transplantation can help improve flap survival，improve clinical efficacy，reduce adverse drug reactions，with high clinical efficacy and drug safety.

[Key words] Free flap transplantation；Low molecular weight heparin calcium；Vascular crisis；Efficacy

游离皮瓣移植术为临床中软组织缺损修复主要方法，随着手术技术成熟，近年来在临床中应用较为广泛[1]。游离皮瓣移植术术后皮瓣存活为影响手术成败关键，游离皮瓣蒂中血液循环为保障皮瓣正常供氧、供血基础，为保障皮瓣存活关键[2]。临床中在游离皮瓣移植术术后常规给予抗凝药物，以预防皮瓣蒂血栓形成和发生，保障血液循环。为探究低分子肝素钙和肝素钠在游离皮瓣移植术中应用效果和安全性，现报道如下。

1 资料与方法

1.1 一般资料

选取2016年2月～2017年2月我院行游离皮瓣移植术患者54例为研究对象，采用计算机抽取住院号法随机分为低钙组和肝素钠组，各27例。两组患者经评估后均有游离皮瓣移植术手术指征，无手术绝对禁忌症；患者均在医师告知下自愿配合完成本次治疗和研究；患者均为一块皮瓣移植；排除合并有凝血功能异常、血小板计数异常、严重肝肾功能不全患者；排除难治性高血压、消化道出血史或有出血倾向患者。……