低分子量肝素钙预防直肠癌术后下肢深静脉血栓的效果观察  

Efficacy observation of low-molecular-weight heparin calcium in preventing lower limb deep vein thrombosis after rectal cancer surgery

作　　者：雷音[1] 张景明[1] 杨光耀 Lei Yin;Zhang Jingming;Yang Guangyao(Department of General Surgery,Beijing Hepingli Hospital,Beijing 100013,China)

机构地区：[1]北京市和平里医院普外科,北京100013

出　　处：《肿瘤研究与临床》2024年第2期94-97,共4页Cancer Research and Clinic

摘　　要：目的探讨低分子量肝素钙预防直肠癌术后下肢深静脉血栓的效果。方法回顾性病例对照研究。回顾性分析2018年2月至2022年2月北京市和平里医院30例直肠癌术后皮下注射低分子量肝素钙患者的临床资料,选择同期穿抗血栓弹力袜患者30例为对照。抗血栓弹力袜组术后依据患者实际情况选择合适的抗血栓弹力袜。低分子量肝素钙组术后第2天给予患者皮下注射低分子量肝素钙。分析两组患者凝血功能指标、术后下肢深静脉血栓形成情况、围术期指标。结果低分子量肝素钙组女性17例,男性13例,年龄(62±12)岁;抗血栓弹力袜组女性18例,男性12例,年龄(63±1)岁。预防前两组患者的血小板计数(Plt)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)及D-二聚体(D-D)水平之间的差异均无统计学意义(均P>0.05);预防后低分子量肝素钙组患者的FIB、D-D水平[(3.3±0.7)g/L、(341±30)μg/L]均低于抗血栓弹力袜组[(4.9±0.6)g/L、(428±40)μg/L](t值分别为9.51、9.61,均P<0.05),但两组患者的Plt、APTT、TT、PT差异均无统计学意义(均P>0.05)。低分子量肝素钙组患者的术后下肢深静脉血栓形成率低于抗血栓弹力袜组[6.67%(2/30)比26.67%(8/30),χ^(2)=4.32,P<0.05]。两组患者术后第1、2、3、4天的骶前引流管引流量均逐渐减少,但两组间引流管引流量差异均无统计学意义(均P>0.05)。低分子量肝素钙组患者的血栓形成时间长于抗血栓弹力袜组[(84±9)h比(73±10)h,t=4.81,P<0.05],但两组患者的术中出血量、手术时间、术后住院时间差异均无统计学意义(均P>0.05)。结论直肠癌术后下肢深静脉血栓形成预防中低分子量肝素钙较抗血栓弹力袜的疗效显著,安全性高。Objective To explore the effect of low-molecular-weight heparin calcium in preventing lower limb deep vein thrombosis after rectal cancer surgery.Methods A retrospective case-control study was conducted.The clinical data of 30 rectal cancer patients with postoperative subcutaneous injection of low-molecular-weight heparin calcium in Beijing Hepingli Hospital from February 2018 to February 2022 were retrospectively analyzed,and 30 patients wearing antithrombotic elastic socks during the same period were selected as controls.In the antithrombotic elastic socks group,the appropriate thrombotic elastic socks were selected according to the actual situation of the patients after operation.Low-molecular-weight heparin calcium group was given subcutaneous injection of low-molecular-weight heparin calcium on the 2nd day after operation.The indexes of coagulation function,situation of postoperative lower limb deep vein thrombosis and perioperative indexes were analyzed.Results The age of patients in the low-molecular-weight heparin calcium group was(62±12)years old,with 17 women and 13 men.The age of patients in the antithrombotic elastic socks group was(63±1)years old,with 18 women and 12 men.Before prevention,there were no significant differences in platelet count(Plt),activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT),fibrinogen(FIB),D-dimer(D-D)levels between the two groups(all P>0.05).After prevention,the FIB and D-D levels of patients in the low-molecular-weight heparin calcium group[(3.3±0.7)g/L and(341±30)μg/L]were lower than those in the antithrombotic elastic socks group[(4.9±0.6)g/L and(428±40)μg/L](t values were 9.51 and 9.61,both P<0.05),but there were no significant differences in Plt,APTT,TT and PT between the two groups(all P>0.05).The rate of lower limb deep vein thrombosis in the low-molecular-weight heparin calcium group was lower than that in the antithrombotic elastic socks group[6.67%(2/30)vs.26.67%(8/30),χ^(2)=4.32,P<0.05].The drainage flow of anterior sacral

关 键 词：直肠肿瘤 下肢深静脉血栓形成 抗血栓弹力袜 低分子量肝素钙 安全性 

分 类 号：R735.37[医药卫生—肿瘤] R543.6[医药卫生—临床医学]