低分子肝素治疗消化系肿瘤合并深静脉血栓患者63例

Treatment with low-molecular-weight heparin for deep venous thrombosis complicated with digestive tract cancer:an analysis of 63 cases

目的:观察低分子肝素钠(LMWH)和常规华法林维持治疗消化系恶性肿瘤合并深静脉血栓形成(DVT)患者的疗效.方法:回顾性分析我院2005-02/2006-12恶性消化系肿瘤合并DVT患者病例资料,比较两组患者的出血发生率、血小板数值变化和血栓再发生率.结果:LMWH组患者治疗3mo内出血发生率为18.8%,3.1%患者出现血小板低于正常值;常规治疗组在治疗3mo内出血发生率为25.8%,6.5%患者出现血小板低于正常值,二组差异均无显著性.但LMWH组在治疗12mo血栓再发生率为9.4%,常规治疗组为29.0%,二者差异有显著性(P<0.05).结论:对恶性消化系肿瘤合并DVT患者,长期应用低分子肝素钠较华法林维持治疗更为方便有效、血栓复发率更低,更为合理.

AIM： To compare therapeutic efficacy of long- term low-molecular-weigh heparin treatment with routine Warfarin treatment for digestive tract cancer complicated with deep venous thrombosis. METHODS： Sixty three digestive tract cancer pa- tients complicated with deep venous thrombosis were retrospectively allotted from February 2005 to December 2006 either into long-term low-mo- lecular-weight heparin treatment group （LMWH group） or into warfarin treatment group （routine care group）. The bleeding rate, the rates of recur- rent venous thromboembolism and the platelet counts of patients of both groups were analyzed. RESULTS： In long-term LMWH group, bleeding occurred in 6 patients （18.8%） and the plate-let count of 1 patient （3.1%） decreased below normal level, which did not show significant dif- ference compared with routine care group （25.8% and 6.5%, respectively）. However, at 12 months, recurrent venous thromboembolism occurred in 3 of 32 cases （9.4%）, which showed significant difference compared with routine care group （29.0%, P 〈 0.05）. CONCLUSION： Long-term low-molecular- weight heparin, more convenient and more ef- fective than routine warfarin therapy, is consid- ered to be more effective for digestive tract can- cer complicated with deep venous thrombosis.