目的 評價低分子肝素預(yù)防婦科術(shù)后深靜脈血栓形成的安全性。方法 計算機檢索PubMed、Embase、Cochrane Library、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫（VIP），收集從建庫至2017年10月低分子肝素預(yù)防婦科術(shù)后深靜脈血栓形成的隨機對照研究（RCT）及隊列研究，采用RevMan 5.3軟件進行Meta-分析。結(jié)果 共納入9項RCT和3項隊列研究。結(jié)果顯示，試驗組（圍手術(shù)期使用低分子肝素）和對照組（圍手術(shù)期未使用低分子肝素）在術(shù)后輸血率、術(shù)后盆腔引流量、凝血酶原時間（PT）、血小板計數(shù)（PLT）方面無顯著性差異。試驗組的活化部分凝血活酶時間（APTT）[MD=1.21，95% CI（0.55，1.86），P=0.0003]長于對照組，而D-二聚體值[MD=-0.21，95% CI（-0.37，-0.06），P=0.006]低于對照組。結(jié)論 低分子肝素預(yù)防婦科術(shù)后深靜脈血栓形成比較安全，不增加術(shù)后輸血率，可以改善術(shù)后高凝狀態(tài)。

Objective To evaluate the safety of low molecular weight heparin (LMWH) in the prevention of deep venous thrombosis after gynecologic surgery. Methods Databases including PubMed, Embase, Cochrane Library, CNKI, WanFang and VIP were retrieved and collected randomized controlled trials (RCTs) and cohort studies from the inception to October 2017. RevMan 5.3 software was used for Meta-analysis. Results A Total of 9 RCTs and 3 cohort studies were included. The results showed that no significant differences were found in postoperative transfusion rates, amount of pelvic drainage, PT and PLT between control group (The patients did not use LMWH during the perioperative period) and experimental group (The patients used LMWH during the perioperative period). The APTT[MD=1.21, 95% CI(0.55, 1.86), P=0.000 3] was longer in experimental group than that of control group. However, the D-dimer[MD=-0.21, 95% CI(0.37, -0.06), P=0.006] was lower in experimental group than that of control group. Conclusion It is safe to use LMWH perioperatively in gynecologic surgery. LMWH couldn't increase postoperative transfusion rates, and could improve postoperative hypercoagulability.