低分子肝素及丹参预防直肠癌术后深静脉血栓的对照研究  

Low-molecular-weight Heparin and Salvia Miltiorrhiza Injection in Prevention of Deep Venous Thrombosis after Rectal Cancer Surgery: a Prospective Randomized Controlled Trial

作　　者：纪烈辰[1] 顾立强[1] 王娟[1] 徐彬[1] 俞林[1] 张锡朋[1] JI Lie-chen;GU Li-qiang;WANG Juan(Department of Colorectal Surgery,Tianjin Union Medical Center,Tianjin(300121),China)

机构地区：[1]天津市人民医院肛肠诊疗中心

出　　处：《中国中西医结合外科杂志》2019年第6期963-967,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：天津市卫生计生委;天津市中医药管理局中医;中西医结合课题（2017059）

摘　　要：目的:研究低分子肝素及丹参注射液预防直肠癌术后深静脉血栓(DVT)形成的疗效及安全性。方法:将行直肠癌根治手术的患者200例,通过随机数字表法分为4组,对照组滴注5%葡萄糖注射液(如患有糖尿病,按比例加入普通胰岛素),丹参注射液组(组1)、低分子肝素组(组2)、低分子肝素联合丹参注射液组(组3),每组50例。均行腹腔镜手术治疗,记录4组一般资料、手术资料、以及术前、术后3天、7天凝血指标,统计术后每组出现DVT以及发生出血倾向例数。结果:组1、组2、组3术后各时间点的PLT、PT、APTT、TT指标与对照组相比,差异无统计学意义(P>0.05);组1术后3天、术后7天的FIB、D-D指标与对照组比较差异无统计学意义(P>0.05);组2术后3天的FIB(6.71±1.87)g/L、D-D(1.14±0.79)mg/L、术后7天的FIB(5.18±2.37)g/L、D-D(0.98±0.63)mg/L水平低于对照组术后3天的FIB(8.78±1.02)g/L、D-D(1.69±0.35)mg/L、术后7天的FIB(5.18±2.37)g/L、D-D(0.98±0.63)mg/L和组1术后3天的FIB(7.83±0.95)g/L、D-D(1.58±0.51)mg/L、术后7天的FIB(6.89±1.58)g/L、D-D(1.21±0.28)mg/L水平,差异有统计学意义(P<0.05);组3术后3天的FIB(4.89±2.51)g/L、D-D(0.67±0.34)mg/L、术后7天的FIB(3.38±0.95)g/L、D-D(0.47±0.25)mg/L水平低于对照组、组1、组2术后3天及术后7天的FIB和D-D水平,差异有统计学意义(P<0.05)。术后组3有1例发生DVT,低于对照组(8例)、组1(7例)、组2(4例)DVT发生例数,差异有统计学意义(P<0.05)。结论:低分子肝素联合丹参注射液可以显著预防直肠癌术后DVT的发生,同时安全性较好。Objective To study the efficacy and safety of low-molecular-weight heparin and Salvia miltiorrhiza injection in preventing deep venous thrombosis after rectal cancer operation.Methods Totally 200 patients who underwent radical resection of rectal cancer were divided into 4 groups randomly,such as control group with 5%Glucose Injection(diabetes mellitus with regular insulin proportionally),Salvia miltiorrhiza injection group(group 1),low-molecular-weight heparin group(group 2),and low-molecular-weight heparin combined with Salvia miltiorrhiza injection group(group 3),with 50 cases in each group,and all patients were treated with laparoscopic operation by the same physician.The statistics of general information,surgical data,and blood coagulation parameters were measured preoperative and postoperative 3 d and 7 d after operation were recorded in 4 groups.The number of patients with DVT and bleeding tendency after operation were counted.Results The PLT,PT,APTT,TT indexes of groups 1,2 and 3 were not significant compared with those of control group(P>0.05).There was no significant difference in FIB and D-D between group 1 and control group 3 and 7 d after operation(P>0.05).FIB(6.71±1.87)g/L and D-D(1.14±0.79)mg/L in 3 d after operation,FIB(5.18±2.37)g/L and D-D(0.98±0.63)mg/L in 7 d after operation in group 2 were lower than those in the control group after 3 d[FIB(8.78±1.02)g/L and D-D(1.69±0.35)mg/L],after 7 d[FIB(5.18±2.37)g/L and D-D group(0.98±0.63)mg/L]and group 1 after 3 d[FIB(7.83±0.95)g/L and D-D(1.58±0.51)mg/L],after 7d[FIB(6.89±1.58)g/L and D-D(1.21±0.28)mg/L],with statistically significant difference(P<0.05).In group 3,the indexes postoperative 3 d[FIB(4.89±2.51)g/L and D-D(0.67±0.34)mg/L],7 d after operation[FIB(3.38±0.95)g/L and D-D(0.47±0.25)mg/L]were lower than those in the control group,group 1 and group 2 postoperative 3d and 7 d after operation,with statistically significant difference(P<0.05).There was only 1 case of DVT in group 3 after operation,there was significant difference c

关 键 词：低分子肝素 丹参注射液 直肠癌 深静脉血栓形成 

分 类 号：R654.4[医药卫生—外科学]