中剂量与标准剂量抗凝药预防性治疗肺癌效果的对比研究  

Preventive Treatment Effect of Medium Dose and Standard Dose Anticoagulants on Lung Cancer:a Comparative Study

作　　者：罗均平 刘先洪 吕逢源 郑刚[1] LUO Junping;LIU Xianhong;LYU Fengyuan;ZHENG Gang(Pulmonary and Critical Care Medicine,Zigong First People's Hospital,Zigong 643000,China)

机构地区：[1]四川省自贡市第一人民医院呼吸与危重症医学科,643000

出　　处：《实用心脑肺血管病杂志》2024年第6期103-106,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的比较中剂量与标准剂量抗凝药预防性治疗肺癌的效果。方法选取2022年1月—2023年1月自贡市第一人民医院呼吸与危重症医学科(PCCM)收治的肺癌患者60例为研究对象。根据预防性抗凝治疗方案的不同,将患者分为中剂量组(n=29)和标准剂量组(n=31)。所有患者接受胸腔镜下肺癌根治术,并于术后接受预防性抗凝治疗,中剂量组抗凝药剂量为1 mg·kg^(-1)·d^(-1),标准剂量组抗凝药剂量为40 mg/d,持续治疗至患者出院或死亡。比较两组出院后30 d内主要结局(静脉血栓栓塞症、动脉血栓形成或全因死亡的复合结果)、次要结局(患者因出现严重呼吸衰竭,常规机械通气无法满足氧合需求而进行体外膜肺氧合治疗)发生率及探索性结局指标(包括偶发心房颤动、采用肾脏替代疗法、转出PCCM情况、入住PCCM时间)、安全性指标(包括大出血、临床相关的非大出血和血小板减少症)。结果两组主要、次要结局发生率比较,差异无统计学意义(P>0.05)。两组偶发心房颤动者占比、接受肾脏替代疗法者占比、转出PCCM者占比、入住PCCM时间比较,差异无统计学意义(P>0.05)。两组大出血、临床相关的非大出血、血小板减少症发生率比较,差异无统计学意义(P>0.05)。结论中剂量与标准剂量抗凝药预防性治疗肺癌的效果相似。Objective To compare the preventive treatment effect of medium dose and standard dose anticoagulants on lung cancer.Methods Sixty patients with lung cancer admitted to Pulmonary and Critical Care Medicine(PCCM)of Zigong First People's Hospital from January 2022 to January 2023 were selected as the study objects.The patients were divided into medium dose group(n=29)and standard dose group(n=31)according to the different prophylactic anticoagulant therapy regimen.All patients underwent thoracoscopic radical resection of lung cancer and received prophylactic anticoagulant therapy after surgery.The dosage of anticoagulants in the medium dose group was 1 mg·kg^(-1)·d^(-1),while the dosage of anticoagulants in the standard dose group was 40 mg/d.Treatment continued until the patient was discharged or died.The incidence of primary outcomes(combined result of venous thromboembolism,arterial thrombosis or all-cause death)and secondary outcomes(the patient underwent extracorporeal membrane oxygenation treatment due to severe respiratory failure and inability of conventional mechanical ventilation to meet oxygenation needs),exploratory outcome indicators(including occasional atrial fibrillation,use of renal replacement therapy,transferring out of PCCM,and length of stay in PCCM)and safety indicators(including major bleeding,clinically related non-major bleeding,and thrombocytopenia)were compared between the two groups within 30 days after discharge.Results There was no statistically significant difference in the incidence of primary and secondary outcomes between the two groups(P>0.05).There was no significant difference in the proportion of patients with occasional atrial fibrillation,the proportion of patients receiving renal replacement therapy,the proportion of patients trancsferring out of PCCM,and length of stay in PCCM between the two groups(P>0.05).There was no significant difference in the incidence of major bleeding,clinically related non-major bleeding and thrombocytopenia between the two groups(P>0.05).Conclus

关 键 词：肺肿瘤 剂量效应关系 药物 预防性抗凝治疗 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤]