低分子肝素对胃癌患者治疗效果及肾功能影响  

Effect of low-molecular heparin on therapeutic effect and renal function in patients with gastric cancer

作　　者：楼建[1] 周月芬[1] 吴敏华[1] 黄剑辉[1] 

机构地区：[1]丽水市中心医院肿瘤内科,浙江省丽水市323000

出　　处：《世界华人消化杂志》2017年第3期276-280,共5页World Chinese Journal of Digestology

摘　　要：目的研究低分子肝素对胃癌患者的治疗效果及其安全性,并分析其对患者肾功能的影响.方法研究对象选取丽水市中心医院2013-05/2015-1收治的胃癌患者96例,运用数字随机法将其分为对照组和观察组,每组各48例,对照组患者行常规化疗方法 ,观察组在常规化疗的基础上,增加低分子肝素皮下注射治疗,比较两组患者治疗效果及并发症发生情况,并比较两组患者治疗后肾功能损伤指标水平.结果治疗两个疗程后,观察组患者总有效率明显高于对照组(85.42%vs 64.58%)(?2=5.556,P=0.018);且治疗后观察组患者血尿素氮、血清肌酐(serum creatinine,Cr)、白蛋白/Cr及尿N-乙酰-?-D-葡萄糖苷酶/Cr水平均明显低于对照组(P<0.01);同时治疗后观察组患者胃肠道反应、深静脉血栓、肺栓塞及肝肾损伤等并发症发生率均明显少于对照组(P<0.05),且两组患者出血情况发生率比较,差异无统计学意义(P>0.05).结论低分子肝素可以明显增加胃癌患者的治疗效果,缩短患者疗程,进而减轻患者家庭的经济负担,且治疗后并发症少,安全性高,同时低分子肝素在治疗肾脏疾病方面,具有明显的抗凝效果,使患者肾功能得到改善,为胃癌患者的临床治疗提供依据.AIM To evaluate the effect of low-molecular heparin on therapeutic effect and renal function in patients with gastric cancer.METHODS Ninety-six patients with gastric carcinoma treated at our hospital from May 2013 to December 2015 were randomly divided into either a control group or an observation group,with 48 cases in each group.The control group was treated with standard chemotherapy,and the observation group was additionally given subcutaneous injections of low molecular heparin on the basis of standard chemotherapy.Therapeutic effect,rate of complications,and renal damage index were compared between the two groups.RESULTS After two courses of treatment,the total effective rate was significantly higher in the observation group than in the control group（85.42%vs 64.58%,χ^2 = 5.556,P = 0.018）;blood urea nitrogen,serum creatinine,albumin/serum creatinine ratio,and urine N-acetyl-β-D-glucosamidase/ serum creatinine ratio were significantly lower in the observation group than in the control group（P〈0.01）;and the rates of gastrointestinal reaction,deep venous thrombosis,pulmonary embolism and liver and kidney dysfunction were significantly lower in the observation group than in the control group（P〈0.05）.However,the incidence of bleeding in the two groups showed no significant difference（P〉0.05）.CONCLUSION Treatment with low-molecular heparin can obviously improve the therapeutic effect in gastric cancer patients,shorten the treatment course,and reduce the economic burden of the family,and is associated with fewer complications in gastric cancer patients.Lowmolecular heparin has obvious anticoagulant effect and can improve renal function in patients with gastric cancer.

关 键 词：低分子肝素 血尿素氮 血肌酐 深静脉血栓 

分 类 号：R735.2[医药卫生—肿瘤]