低分子肝素对食管癌患者术后血栓性疾病发生的影响  

The Effect of Low Molecular Weight Heparin on Thrombotic Diseases in Postoperative Esophageal Carcinoma Patients

作　　者：谢晓阳[1] 李季[1] 易军[1] 高健[1] 

机构地区：[1]四川省内江市第一人民医院胸心外科,641000

出　　处：《实用癌症杂志》2014年第6期654-656,共3页The Practical Journal of Cancer

摘　　要：目的探讨低分子肝素对食管癌患者术后血栓性疾病发生的影响.方法将360例行食管癌手术的患者随机分为观察组与对照组,每组180例.观察组于术后第1天皮下注射低分子肝素4000～6150IU或低分子肝素钠4000～6000IU,每天1次,连用5d.对照组给予常规方法进行治疗.术前及术后5天测定患者的血小板（PLT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fib）、D-二聚体（D-D）及凝血酶原时间（PT）.观察2组食管癌手术后的胸腔积液引流量.结果手术前2组食管癌患者PT明显缩短,D-D及Fib均明显高于正常范围,手术后第1天2组食管癌患者的PT明显缩短,DD较术前明显升高（P〈0.05）.观察组术后第2天PT达到最低水平,DD及Fib达到最高水平.术后第5天观察组PT较术前及术后第1天延长,D-D及Fib明显降低.观察组与对照组相比,Fib、PT在术后2～5天及D-二聚体在术后1～5天的差异均有统计学意义（P〈0.05）.食管癌手术后观察组的平均胸腔积液引流量为（527.9±132.5）ml,对照组的平均积液引流量为（531.6±121.4）ml,2组差异无统计学意义（χ2=0.385,P〉0.05）.结论经预防性的给予低分子肝素进行治疗后,可以明显降低食管癌患者术后血栓性疾病的发生率.Objective To explore the effect of low molecular weight heparin on thrombotic disease in postoperative esophageal carcinoma. Methods 360 cases of esophageal cancer were randomly divided into the observation group and the control group( n = 180). The observation group received subcutaneous low molecular weight heparin or subcutaneous low molecular weight heparin sodium 4 000 ~ 6 000 IU daily from the 1st of surgery for 5 days,and the control group received conventional treatment. PLT,APTT,Fib,D-D and PT of the 2 groups were detected. Pleural effusion drainage of the 2 groups were compared. Results Before surgery,PT was shorter than normal range,but Fib and D-D were higher. First day after surgery,PT decreased significantly,while D-D increased than before surgery( P < 0. 05). On the 2nd day,the PT reached the lowest level,but the Fib and D-D reached the highest level. On the 5th day,the PT of the observation group extended while Fib and D-D decreased significantly. Fib and PT in 2 ~ 5 days and D-D in 1 ~ 5 days of the 2 groups had statistical significance( P < 0. 05). The postoperative average pleural effusion drainage of the observation group and the control group were( 527. 9 ± 132. 5) ml and( 531. 6 ± 121. 4) ml,there had no statistical difference( χ2= 0. 385,P > 0. 05). Conclusion Preventive low molecular weight heparin treatment can significantly reduce the incidence of thrombotic diseases.

关 键 词：低分子肝素 食管癌 血栓性疾病 

分 类 号：R735.1[医药卫生—肿瘤]