بررسی مقایسه‌ای تغییرات دی‌دایمر در زنان مبتلا به دیابت بارداری با زنان سالم پس از سزارین انتخابی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه جراحی زنان، دانشکده پزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

2 دانشجوی کارشناسی هوشبری، دانشکده پیراپزشکی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

3 استادیار گروه جراحی عمومی و عروق، مرکز تحقیقات تنفس و خواب راحت، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

چکیده

مقدمه: با توجه به افزایش شیوع دیابت بارداری که از اندیکاسیون‌های انجام سزارین است که هر دوی این موارد اثرات نامطلوبی بر مسیر انعقادی دارند؛ مطالعه حاضر با هدف مقایسه مقدار دی‌دایمر در دو گروه از زنان باردار سالم و دیابتی بعد از سزارین و بررسی خطرات انعقادی بعد از سزارین انجام شد.
روش‌کار: این مطالعه توصیفی در سال 1398 بر روی 150 زن سالم و مبتلا به دیابت بارداری کاندید سزارین انتخابی در بیمارستان الزهراء تبریز انجام شد. میزان دی‌دایمر در روز قبل جراحی، روز بعد عمل، روز هفتم و چهاردهم برای هر دو گروه اندازه‌گیری شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های تی مستقل، کای اسکوئر، رگرسیون و همبستگی اسپیرمن انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: میزان دی‌دایمر در روز بعد از جراحی، بیشترین اختلاف آماری معنادار بین زنان سالم و زنان مبتلا به دیابت بارداری وجود داشت (001/0=p)؛ همچنین در 7 روز پس از جراحی (012/0=p) و 14 روز پس از جراحی (039/0=p) نیز میزان دی‌دایمر در زنان با دیابت بارداری به‌طور معناداری بالاتر از زنان سالم بود. همچنین مشخص شد که مصرف سیگار (031/0=p) و سابقه بارداری قبلی (041/0=p) با افزایش سطح دی‌د‌ایمر در زنان با دیابت بارداری به‌طور معناداری ارتباط دارند.
نتیجه‌گیری: دیابت بارداری در افزایش سطح دی‌دایمر نقش دارد و می‌تواند منجر به افزایش سطح پلاسمایی دی‌دایمر گردد.

کلیدواژه‌ها


عنوان مقاله [English]

Changes of D dimer in women with gestational diabetes and healthy women after elective cesarean section

نویسندگان [English]

  • Fatemeh Mallah 1
  • Mina Zeinalzadeh 2
  • Dara Alvandfar 3
1 Associate Professor, Department of Gynecology Surgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
2 B.Sc. student of Anesthesia, School of Paramedical, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Assistant Professor, Department of General and Vascular Surgery, Comfortable Breathing and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
چکیده [English]

Introduction: Due to the increasing prevalence of gestational diabetes, which is one of the indications for cesarean section, and both of these cases have adverse effects on the coagulation pathway, this study was performed with aim to compare the level of D-dimer in two groups of healthy and diabetic pregnant women after cesarean section to assess the coagulation risks after cesarean section.
Methods: This descriptive study was performed in 2019 on 150 healthy and gestational diabetes women who were candidates for elective cesarean section in 2019. The level of D-dimer was measured on the day before surgery, the day after surgery, on the seventh and fourteenth days for both groups. Data were analyzed by SPSS software (version 22) and Independent t-test, Chi-square, regression and Spearman correlation tests. P<0.05 was considered statistically significant.
Results: The level of D-dimer on the day after surgery had the most statistically significant difference between healthy and gestational diabetes women (P=0.001). Also, on seven days after surgery (P=0.012) and 14 days after surgery (P=0.039), the amount of D-dimer was significantly higher in women with gestational diabetes than healthy women. It was also found that smoking (P=0.031) and previous history of pregnancy (P=0.041) were significantly associated with increased D-dimer levels in women with gestational diabetes.
Conclusion: Gestational diabetes plays a role in increasing the level of D-dimer and can lead to an increase in plasma level of D-dimer.

کلیدواژه‌ها [English]

  • Cesarean section
  • D-dimer
  • Gestational diabetes
  • Deep Vein Thrombosis
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