常规加延续干预模式在胸腔镜肺癌根治术后患者预防静脉血栓栓塞症中的应用研究  

Study on the application of combined routine and extended intervention mode in preventing venous thromboembolism in patients after thoracoscopic radical resection of lung cancer

作　　者：吴艳[1] 康晓艳[1] 毕昭雪 吾甫尔·依马尔[2] Wu Yan;Kang Xiaoyan;Bi Zhaoxue;Wufuer·Yimaer(Department of Thoracic Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China;Department of Vascular Thyroid Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang,China)

机构地区：[1]新疆医科大学第一附属医院胸外科,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院血管甲状腺外科,新疆乌鲁木齐830054

出　　处：《血管与腔内血管外科杂志》2025年第3期387-391,共5页Journal of Vascular and Endovascular Surgery

基　　金：新疆医科大学第一附属医院青年科研起航专项基金项目(2022YFY-QNRC-08);新疆维吾尔自治区自然科学基金(2021D01C325)。

摘　　要：目的探讨常规加延续干预模式对胸腔镜肺癌根治术后发生静脉血栓栓塞症(VTE)的预防价值。方法收集2022年8月至2023年10月于新疆医科大学第一附属医院接受胸腔镜肺癌根治术的122例患者的临床资料,根据患者是否接受了常规加延续干预模式将患者分为观察组(n=63)和对照组(n=59)。对照组患者住院期间接受低分子肝素联合间歇性气压治疗,出院后适当运动,避免久坐;观察组患者在此基础上采取延续干预模式,即出院后服用利伐沙班、穿戴医用弹力袜1个月。比较两组患者的肺癌病情和手术相关指标,胸腔镜肺癌根治术至出院后1个月内的观察时间以及VTE、出血、感染、恶心呕吐的发生率。结果两组患者的肺癌部位、非小细胞肺癌比例、肿瘤大小、手术时间、术中出血量、术中输血比例和术中低体温发生率比较,差异均无统计学意义(P﹥0.05)。术后至出院后1个月内的随访期间,两组患者的观察时间、出血的发生率、感染的发生率和恶心呕吐的发生率比较,差异均无统计学意义(P﹥0.05);两组患者VTE的发生率比较,差异有统计学意义(P﹤0.05)。对照组发生VTE的7例患者中,有2例患者的VTE发生于住院期间,5例患者的VTE发生于出院后的1个月内。结论常规加延续干预模式可以明显降低患者胸腔镜肺癌根治术后短期内发生VTE的风险,并具有较高的安全性,值得推广并进一步观察研究。Objective To investigate the preventive value of combined routine and extended intervention mode for venous thromboembolism(VTE)after thoracoscopic radical resection of lung cancer.Method The clinical data of 122 patients who underwent thoracoscopic radical resection of lung cancer at the First Affiliated Hospital of Xinjiang Medical University from August 2022 to October 2023 were collected.Patients were divided into observation group(n=63)and control group(n=59)based on whether they received the combined routine and extended intervention mode.The control group received low molecular weight heparin combined with intermittent pneumatic compression during hospitalization and was advised to engage in moderate physical activity and avoid prolonged sitting after discharge.The observation group,in addition to the above measures,received extended interventions,including a 1-month course of rivaroxaban and the use of medical compression stockings after discharge.The lung cancer condition and surgical related indicators,the observation time,the incidence of VTE,the incidence of bleeding,the incidence of infection,the incidence of nausea and vomiting from thoracoscopic lung cancer radical surgery to one month after discharge were compared between the two groups of patients.Result There were no statistically significant differences in the location of lung cancer,proportion of non-small cell lung cancer,tumor size,surgical time,intraoperative blood loss,intraoperative blood transfusion ratio,and incidence of intraoperative hypothermia between the two groups of patients(P>0.05).During the follow-up period from postoperative to one month after discharge,there were no statistically significant differences in the observation time,incidence of bleeding,incidence of infection,and incidence of nausea and vomiting between the two groups of patients;the incidence of VTE was compared between two groups of patients,and the difference was statistically significant(P<0.05).Among the 7 patients in the control group who experienced VTE,2

关 键 词：常规干预 延续干预 胸腔镜肺癌根治术 静脉血栓栓塞症 

分 类 号：R543[医药卫生—心血管疾病]