摘要
目的探讨低分子肝素预防乳腺癌根治术后中心静脉置管静脉血栓形成的有效性。方法收集2020年8月至2021年6月南京医科大学附属医院收治的98例行中心静脉置管的乳腺癌术后患者临床资料,根据治疗方案的不同将患者分为对照组和观察组,各49例。对照组患者术后中心静脉置管前和化疗期间不使用任何抗凝药物,观察组患者术后采用低分子肝素进行预防性治疗。比较两组患者中心静脉置管前后的凝血功能指标,包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)水平和D-二聚体(D-D)水平。比较两组患者置管前后的上肢周径测量情况、血流速度。结果置管后,观察组患者的APTT、PT均明显短于对照组患者,Fib、D-D水平均明显高于对照组患者,差异均有统计学意义(P<0.05)。置管后,观察组患者的上肢周径值、血流速度均明显低于对照组患者,差异均有统计学意义(P<0.05)。置管后,根据管腔堵塞程度,观察组患者管腔内有血栓形成,静脉管腔内径变窄,回声充填血管腔;彩色多普勒超声检查结果显示管腔内血流充盈。对照组患者的超声检查结果显示管腔增宽、完全实性回声充填、血流充盈缺损。结论对于术后行中心静脉置管的乳腺癌患者,低分子肝素可以有效预防静脉血栓形成,使患者在安全地使用中心静脉置管的同时,进一步降低血栓形成的风险。
Objective To analyze the effect of low molecular weight heparin(LMWH)in preventing central vein catheterization-related venous thrombosis after radical mastectomy.Method The clinical data of 98 postoperative breast cancer patients who underwent central vein catheterization admitted to the Affiliated Hospital of Nanjing Medical University from August 2020 to June 2021 were collected,and the patients were divided into the control group and the observation group according to different treatment options,each 49 cases.Patients in the control group were free of any anticoagulants before central vein catheterization and during chemotherapy,and patients in the observation group were treated with LMWH for preventive treatment after surgery.The coagulation function indicators of the two groups before and after central vein catheterization,including prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib)level,and D-dimer(D-D)level was compared.The measurement of the circumference of the upper limbs before and after the intubation of the two groups of patients and the blood flow velocity of the two groups of patients were also compared.Result After the catheterization,the value of APTT and PT in the observation group were significantly shorter than those of the control group,and the levels of Fib and D-D were significantly higher than those of the control group.The differences were statistically significant(P<0.05).After the intubation,the upper limb circumference and blood flow velocity of the observation group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).After the catheterization,the observation group had thrombosis in the lumen according to the degree of lumen blockage,the inner diameter of the venous lumen was narrowed,and the blood vessel cavity was filled with echo.The results of color Doppler ultrasound showed that the blood flow was filled with the lumen.The ultrasound examination results of the control group showed widene
作者
李振
徐铮
刘镇
胡睿
梁烁
Li Zhen;Xu Zheng;Liu Zhen;Hu Rui;Liang Shuo(Department of Breast Surgery,Jiangsu Province Hospital of Chinese Medicine(Affiliated Hospital of Nanjing University of Chinese Medicine),Nanjing 210029,Jiangsu,China;Department of Breast Surgery,the Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Vascular Surgery,the Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)
出处
《血管与腔内血管外科杂志》
2021年第10期1231-1234,1249,共5页
Journal of Vascular and Endovascular Surgery
基金
江苏省科技项目(BK20191089)。
关键词
低分子肝素
乳腺癌
中心静脉置管
静脉血栓
low molecular weight heparin
breast cancer
central vein catheterization
venous thrombosis
