目的 比較低分子肝素和貝米肝素治療產(chǎn)后出血所致彌漫性血管內(nèi)凝血的療效。方法 選取2014年11月—2017年11月新鄭市人民醫(yī)院婦產(chǎn)科收治的70例產(chǎn)后出血致彌漫性血管內(nèi)凝血患者為研究對象，按照隨機數(shù)字表法分為對照組和治療組，每組各35例。對照組皮下注射8.0 mg貝米肝素鈉注射液，3次/d；治療組皮下注射0.4 mL低分子量肝素鈣注射液，1次/d，根據(jù)患者凝血狀態(tài)加以調(diào)整。兩組患者治療1周后觀察病情。觀察兩組的臨床療效，比較兩組患者治療前后C反應(yīng)蛋白（CRP）、D-二聚體（D-D）、活化部位凝血活酶時間（APPT）和凝血酶原時間（PT）的變化情況。結(jié)果 治療后，治療組總有效率88.57%顯著高于對照組的77.14%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。兩組患者治療后CRP、D-D、APPT、PT水平均顯著低于同組治療前（P<0.05）；治療后，治療組CRP、D-D、APPT、PT水平低于對照組（P<0.05）。結(jié)論 低分子肝素較貝米肝素治療產(chǎn)后出血所致彌漫性血管內(nèi)凝血的療效顯著，可有效降低患者血清中的CRP及D-D水平，具有一定的臨床推廣應(yīng)用價值。

Objective To compare the efficacy of low molecular weight heparin and bemiparin heparin in treatment of diffuse intravascular coagulation caused by postpartum hemorrhage. Methods 70 Patients with diffuse intravascular coagulation due to postpartum hemorrhage admitted to the Department of Obstetrics and Gynecology of Xinzheng People's Hospital from November 2014 to November 2017 were selected as the research objects. According to the random number table method, the patients were divided into the control group and the treatment group, 35 cases in each group. The control group was subcutaneously injected with 8.0 mg Bemiparin Sodium Injection for 3 times/day. The treatment group was subcutaneously injected with Low Molecular Weight Heparin Calcium Injection 0.4 mL, once daily. The dosage was adjusted according to the patient's clotting state. Patients in both groups were observed after 1 week of treatment. The clinical efficacy of the two groups was observed, and the changes of C-reactive protein (CRP), D-dimer (D-D), activated site thrombin time (APPT) and prothrombin time (PT) before and after treatment were compared. Results After treatment, the total effective rate of 88.57% in the treatment group was significantly higher than 77.14% in the control group, and the difference between two groups was statistically significant (P<0.05). The levels of CRP, D-D, APPT and PT in both groups after treatment were significantly lower than those before treatment (P<0.05). After treatment, CRP, D-D, APPT and PT levels in the treatment group were lower than those in the control group (P<0.05). Conclusion Low molecular weight heparin has curative effect in treatment of diffuse intravascular coagulation due to postpartum hemorrhage, and can effectively reduce the serum CRP and D-D levels in patients, which has certain clinical application value.

R984