直肠癌术后下肢深静脉血栓形成的原因及防治

Causes,prophylaxis and therapy of deep venous thrombosis in the lower extremities after operations for rectal carcinoma.

目的 探讨直肠癌术后下肢深静脉血栓形成 (LDVT)的原因及其防治。方法 回顾性研究了自 1991年 1月至 1999年 6月间收治的 8例直肠癌术后LDVT病人。结果 本组LDVT占同期深静脉血栓形成的2 1% (8/ 384) ,占同期直肠癌手术治疗的 1 2 % (8/ 6 5 6 )。左侧 5例 ,右侧 3例。术后早期发生的LDVT有 7例 ,均为截石体位手术 ,平均发生于术后第 10天 ;另 1例 2年后发生。表现为下肢肿胀 8例。 8例均得到彩色多普勒超声检查的证实。本组病人早期用祛聚、抗凝和溶栓治疗后获得良好的效果。结论 LDVT的病因是多因素的 ,早期诊断和及时处理是改善预后的关键 ,并强调预防的重要性。

Objective\ To investigate the causes,prophylaxis and therapy of deep venous thrombosis in the lower extremities(LDVT)after operations for rectal carcinoma.Methods\ 8 patients with LDVT after operations for rectal cancer from January 1991 to June 1999 were collected and analyzed retrospectively.Results\ The patients with LDVT were 2 1%(8/384)of overall deep venous thrombosis of the same period,and 1 2%(8/656)of all the cases undergoing operations for rectal cancer.The left leg was involved in 5 of the patients,and right leg in 3 cases One case with LDVT occurred after 2 years following operation for rectal cancer,and the other 7 patients in the postoperative early stage,which were placed in the lithotomy position during the operation and LDVT appeared 10 days after operation on the average.The main manifestations were lower limbs swelling(n=8).The 8 patients were confirmed by the color Doppler ultrasonography.They were all treated early by anticoagulation,platelet function suppressants and fibrinolytic therapy and their effects were satisfactory.Conclusion\ The causes of LDVT are various.The early diagnosis and therapy in time is the key to improve prognosis.The importance of prevention of LDVT after operation for rectal cancer should always be emphasized.