低分子肝素对胃癌术后静脉血栓栓塞预防性治疗的价值  

The Therapeutic Value of Low Molecular Weight Heparin on Thrombotic Disease in Postoperative Gastric Carcinoma Patients

作　　者：钟洁 刘小孙[1] ZHONG Jie;LIU Xiao-sun(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Zhejiang University,School of Medicine,Hangzhou,310003,China)

机构地区：[1]浙江大学医学院附属第一医院胃肠外科,浙江杭州310000

出　　处：《临床医药文献电子杂志》2018年第20期5-8,共4页Electronic Journal of Clinical Medical Literature

基　　金：浙江省省级科技计划公益项目(2015C33174)

摘　　要：目的探讨低分子肝素(low molecular weight heparin,LMWH)对胃癌术后静脉血栓栓塞的预防性治疗价值,评价其有效性和安全性。方法将入住浙江大学医学院附属第一医院胃肠外科的391例胃癌相关手术患者分为观察组和对照组。观察组于术后予以LMWH预防性干预治疗,对照组未给予LMWH等抗凝治疗。研究两组患者临床病理资料、凝血功能指标、术后并发症等信息。结果术后观察组的D-二聚体明显低于对照组(P<0.01),且肺栓塞的发病率也比对照组低(0.6%vs1.8%),而两组出血等并发症的发生率无显著性差异。结论 LMWH对预防胃癌患者术后静脉血栓栓塞安全可行。Objective To investigate the value of low molecular weight heparin(LMWH)in the treatment of thrombotic diseases in Chinese patients with gastric cancer.Methods 391 patients,who underwent gastric cancer surgery at our institute from March 2014 to March 2016,were divided into two groups:the LMWH group and the control group.The LMWH group received subcutaneous injection of LMWH(Nadroparin Calcium)3075 U every 12 hours from the 2nd^7th day postoperatively until discharge.The control group was not given anticoagulant therapy.Two groups of patients were measured the platelet count(PLT),prothrombin time(PT),activated partial thromboplastin time(APTT)and D-dimer(D-D)respectively before operation and before discharge.The complications after operation in two groups were observed.Results Before surgery,D-D in 2 groups of patients with gastric cancer were higher than normal range.Before discharge,the PLT,PT,APTT,and D-D of 2 groups were significantly higher than those before operation(P<0.01).The postoperative D-D of the control group was higher than the LMWH group statistically(P<0.01).The incidence of postoperative PE in the LMWH group was lower than that in the control group(0.6%vs 1.8%),although the difference was not significant.There was no significant difference in the incidence of complications such as bleeding.Conclusion LMWH is safe and feasible in preventing postoperative thromboembolic disease in Chinese patients with gastric cancer.

关 键 词：静脉血栓栓塞 胃癌 低分子肝素 预防 安全性 

分 类 号：R654.3[医药卫生—外科学]