D-dimer Monitoring and Application of Low Molecular Weight Heparin in Prevention of Venous Thrombotic Disease after Gynecological Operation

Objective To predict the incidence of thrombosis through monitoring the post-operation D-dimer level in patients with high risky factors of venous thrombosis,and to reduce the incidence of thrombosis by adopting low molecular weight heparin on patients with an obvious rise of post-operation D-dimer level.Methods62 patients with high risk of VTE factors after gynecological operations from May 2014 to May 2016 were selected and dividedinto 2 groups, 32 patients in study group and 30 patients in comparison group. We monitored the D-dimer levels of both groups at different time points,respectively 1, 2, 3 and 7 days after operations. Any patient in the study group had a D-dimer content ≥ 5 μg/mL within 24-72 hours post-operation,was given hypodermic injection of 4 000 IU enoxaparin sodium once a day for a consecutive 5-7 days to prevent venous thrombosis.In the comparison group, only monitor their D-dimer levels without giving prophylactic injection of enoxaparin sodium.Results Post-operation D-dimer levels in both the study group and the comparison group were higher than those before operations. In the study group, 15 cases of D-dimer level≥5 μg/mL and 2 cases of thrombosis occurred, while in the comparison group 13 cases of D-dimer level≥5ug/ml and 9 cases of thrombosis occurred. The incidence of thrombosis was 13.33% and 69.23%, respectively, the difference had a statistical significance(p <0.05).Conclusions Patients with a significantly higher D-dimer leve land ≥ 5ug/ml after operations are more likely to occur post-operationthrombosis. Monitoring of post-operation D-dimer levelhas a clinical value on predicting thrombosis; prophylactic injection of enoxaparin sodium on patients with a significantly higher D-dimer level and ≥ 5μg/mL is effective to prevent venous thrombosis and thus reduce the incidence of thrombotic disease.