摘要
目的探讨围术期预防性抗凝治疗对降低肺癌患者术后下肢静脉血栓形成发病率的效果。方法将164例肺癌患者随机分为试验组与对照组各82例,2组患者术后均每日使用双下肢间隙性充气加压治疗2次,试验组于围术期预防性使用低分子肝素皮下注射,对照组则不予以对应处理。对比2组患者术前、术后的凝血功能、血栓弹力图指标和双下肢静脉血栓形成发病率。结果术后第7日,试验组13.0%(7/54)患者发生下肢静脉血栓形成,低于对照组的29.6%(16/54);D-二聚体水平低于对照组(P均<0.05)。术后1个月内,试验组13.8%(9/65)患者发生下肢静脉血栓形成,低于对照组的28.1%(18/64)(P<0.05)。2组患者术前、术后第3日、术后第7日其他凝血功能指标和血栓弹力图指标等均无差异(P均>0.05)。结论低分子肝素预防性抗凝治疗可以降低肺癌术后下肢静脉血栓形成的发病率。
Objective To evaluate the efficacy of perioperative thromboprophylaxis in lowering the postoperative incidence of venous thromboembolism(VTE)of the lower limbs in lung cancer patients.Methods 164 patients diagnosed with lung cancer were randomly divided into the experimental(n=82)and control groups(n=82).Patients in both groups were treated with interstitial inflatable compression twice a day after surgery.In the experimental group,prophylactic anticoagulation was given by hypodermic injection of low-molecule-weight heparin(LMWH)during perioperative period,and no corresponding treatment was delivered in the control group.The blood coagulation,thrombelastogram and the incidence of VTE of bilateral lower limbs before and after surgery were statistically compared between two groups.Results On the 7th d after operation,the incidence of VTE of bilateral lower limbs was 13.0%(7/54)in the experimental group,significantly lower than 29.6%(16/54)in the control group.The D-dimer level in the experimental group was significantly lower compared with that in the control group(both P<0.05).At postoperative 1 month,the incidence of VTE of bilateral lower limbs was 13.8%(9/65),significantly lower than 28.1%(18/64)in the control group(P<0.05).The blood coagulation and thrombelastogram indexes before,3 d and 7 d after surgery did not significantly differ between two groups(all P>0.05).Conclusion Prophylactic anticoagulation by LMWH can reduce the postoperative incidence of VET of the lower limbs in lung cancer patients.
作者
谢泽华
黄文海
易永盛
梁桂芳
林志潮
Xie Zehua;Huang Wenhai;Yi Yongsheng;Liang Guifang;Lin Zhichao(Department of Thoracic Surgery,Jiangmen Central Hospital,Affiliated Jiangmen Hospital of Sun Yat-sen University,Jiangmen 529000,China)
出处
《新医学》
CAS
2022年第1期22-27,共6页
Journal of New Medicine
基金
广东省医学科研基金(B2018239)
白求恩·爱惜康卓越外科基金项目(HZB-20181119-29)。
关键词
静脉血栓形成
低分子肝素
肺癌
围术期
Venous thromboembolism
Low-molecule-weight heparin
Lung cancer
Perioperative period
