胃肠道恶性肿瘤术后肺栓塞的预防与治疗  

Prevention and treatment of acute pulmonary embolism following major surgery of gastrointestinal malignant tumors

作　　者：魏刚[1] 邵永胜[1] 赵建国[1] 张应天[1] 

机构地区：[1]江汉大学附属医院普外科,武汉430015

出　　处：《腹部外科》2007年第4期212-214,共3页Journal of Abdominal Surgery

摘　　要：目的针对目前外科临床不重视围手术期抗凝治疗及术后滥用止血药的状况,提出对肺栓塞中、高危病人实施围手术期抗凝治疗。方法根据我科2005年诊治的急性肺栓塞5例的诊疗体会制定常规,对2006年1月～2007年5月胃肠道恶性肿瘤大手术后肺栓塞中、高危病人共38例行预防性抗凝治疗。结果急性肺栓塞5例中,死亡3例,存活2例,Wells及Wicki评分均为高危;中、高危病人38例中,并发出血1例,无肺栓塞病例。结论对胃肠道恶性肿瘤大手术后肺栓塞中、高危病人行预防性抗凝治疗,安全且有效。Objective To study perioperative anticoagulant therapy for patients at moderate or high risk of pulmonary embolism（PE）. Methods The norm was formulated from experience of diagnosis and treatment of 5 patients with acute pulmonary embolism patients in 2005, and accordingly, preventive anticoagulant therapy was performed on 38 patients at moderate or high risk of PE after major surgery of gastrointestinal malignant tumors during Jan. 2006 to May 2007. Results Three cases died and 2 survived among 5 PE patients with high risk according to Wells and Wicki Model; Hemorrhage occurred in 1 out of 38 cases（2. 63 %）, but no PE occurred among 38 patients at moderate or high risk of PE. Conclusion Preventive anticoagulant therapy is safe and effective for patients at moderate or high risk of PE after major surgery of gastrointestinal malignant tumors.

关 键 词：肺栓塞 胃肠肿瘤 综合预防 抗凝药 

分 类 号：R473.71[医药卫生—护理学]