巴曲亭在NSCLC手术低分子肝素抗凝中的应用研究

Application of hemocoagulase with low molecular heparin during operation for patients with non-small cell lung cancer

目的探讨肺癌患者术中配合低分子肝素抗凝时加用巴曲亭对预防下肢静脉血栓形成的临床疗效。方法选取137例行肺叶或全肺切除术治疗的非小细胞肺癌患者,随机分为观察组和对照组。观察组术中注射巴曲亭,对照组给予相同剂量的安慰剂,两组患者均在术后12小时内开始预防性使用低分子肝素。观察比较两组患者术中出血量、术后总引流量、血液凝固水平及下肢静脉血流情况。结果观察组患者的术中出血量、术后总引流量分别为(354.32±75.20)mL、(211.52±72.16)mL,与对照组比较差异有统计学意义(P<0.05)。手术前后血液凝固水平两组差异不明显(P>0.05)。术后5天下肢深静脉彩色多普勒超声检查示,观察组2例发生下肢深静脉血栓,对照组1例,其余患者的下肢深静脉回流速度和回流血量差异不明显(P>0.05)。结论术中应用巴曲亭能够明显减少应用低分子肝素抗凝的肺癌术后患者的出血量,且不会增加下肢静脉血栓的发生率,具有一定的临床推广价值。

Objective To evaluate the application of hemocoagulase with low molecular heparin in surgery for patients with non- small cell lung cancer. Methods One hundred and thirty seven patients with non-small cell lung cancer undergoing surgical theatment were enrolled in the study. Patients were randomly assigned to receive hemocoagulase injection （observe group） or placebo （control group）, both group received low molecular heparin for anticoagulation after surgery. The operative blood loss and postoperative drainage, blood coagulation and venous blood flow were compared between two groups. Results In observe group, the average operative blood loss and postoperative drainage were 354.32 ± 75.20 mL and 211.52 ±72.16 mL, which were lower than those in control group （P 〈 0.05 ）. There was no significant difference in coagulation levels before and after surgery between two groups （ P 〉 0.05）. Color Doppler ultrasonography revealed 2 cases of deep venous thrombosis in observe group and 1 in control group at 5d after surgery; and there were no significant differences in deep venous reflux speed and return blood volume between two groups （P 〉 0. 05）. Conclusion The application of hemocoagulase can significantly reduce blood loss with low molecular heparin anticoagulation during the operation for non-small cell lung cancer patients, without increasing the risk of deep vein thrombosis.