肺癌患者血栓前状态监测及护理

PRETHROMBOTIC STATE MONITORING AND NURSING OF PATIENTS WITH LUNG CANCER

目的:分析肺癌患者血栓前状态(PTS)监测的临床价值,并探究相关护理[1~6]。方法:对201-06~2018-06本院收治的68例原发性肺癌患者(肺癌组)及50例同期本院门诊体检正常者(对照组)的凝血及纤溶指标分别进行监测,包括血浆活化部分凝血活酶时间(APTT)、活化凝血活酶时间(PT)、纤维蛋白原(FIB)、血小板计数(PLT)、D-二聚体(D-D)及抗凝血酶Ⅲ(AT-Ⅲ)活性。结果:肺癌组APTT、FIB、PLT、D-D水平显著高于对照组,AT-Ⅲ活性显著低于对照组,差异有统计学意义(P<0.05);不同病理类型及不同分化程度肺癌患者凝血及纤溶指标比较,差异无统计学意义(P>0.05);肺癌患者TNM分期越晚,FIB、D-D水平越高,差异有统计学意义(P<0.05);肺癌远处转移患者FIB、D-D水平高于无远处转移患者,差异有统计学意义(P<0.05)。结论:肺癌患者存在不同程度的凝血纤溶功能异常,可导致血液高凝,促进血栓形成,且血浆FIB、D-D水平与患者预后密切相关,应引起临床重视,并进行早期干预。

Objective:To analyze the clinical value of pre-thrombotic state(PTS)monitoring in patients with lung cancer and to explore related nursing.Methods:The Indexes of coagulation and fibrinolysis from 68 patients with primary lung cancer(lung cancer group)and 50 patients with normal physical examination(control group)from June 2017 to June 2018 were monitored,including plasma activated partial thromboplastin time(APTT),activated thromboplastin time(PT),fibrinogen(FIB),platelet count(PLT),D-dimer(DD),and antithrombinⅢ(AT)-Ⅲ)activity.Results:The levels of APTT,FIB,PLT and DD in lung cancer group were significantly higher than those in the control group,the activity of AT-Ⅲwas significantly lower than that in the control group(P<0.05).There was no significant difference in the indexes of coagulation and fibrinolysis of lung cancer patients with different pathological types and different degrees of differentiation(P>0.05).The later the TNM stage of lung cancer patients,the higher the FIB and DD levels(P<0.05).The level of FIB and D-D in patients with distant metastasis of lung cancer was higher than that in patients with non-distant metastasis of lung cancer(P<0.05).Conclusion:Patients with lung cancer have different degrees abnormality of coagulation and fibrinolysis,which can lead to hypercoagulability of blood and promote thrombosis.Plasma levels of FIB and D-D are closely related to the prognosis of patients.It should be paid attention to clinical attention and early intervention.