止血药对结肠癌患者术后下肢深静脉血栓形成的影响

Impact of Hemocoagulase on Postoperative Deep Vein Thrombosis of Colon Cancer Patients

目的探讨止血药对结肠癌患者术后下肢深静脉血栓形成的影响。方法选择结肠癌患者80例,随机分为研究组(未使用止血药组)和对照组(止血药组),每组40例。检测比较2组D-D二聚体、血浆凝血酶原时间(PT)、血浆凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制剂(PAI-1)和血小板计数(PT)的变化。结果 2组患者术后D-D、t-PA、PAI-1的含量明显比术前增高,PT、APTT术后比术前延长,TT明显缩短,PLT含量减少;研究组D-D、t-PA、PAI-1、APTT低于对照组,TT、PLT高于对照组,组间效应比较有统计学意义(P<0.05);除PLT外,其他指标组别和时间的交互作用存在显著性差异(P<0.05)。对照组DVT发生率为25.0%(10/40),高于研究组12.5%(5/40),但组间差异没有统计学意义(χ2=2.051,P=0.152)。结论结肠癌患者手术后体内血液处于高凝状态,易导致下肢深静脉血栓形成;止血药会加重血液的高凝状态,手术后应考虑减少止血药的使用。

Objective To investigate the impact of hemocoagulase on postoperative deep vein thrombosis of colon cancer patients. Method 80 colon cancer patients were randomly divided into the study group （ without applying Hemocoagulase） and the control group （ applying Hemocoagulase）, with 40 patients in each group. D-D dimer, prothrombin time （ TT）, thrombin time（ TT）, activated partial thromboplastin time （APTT）, tissue-type plasminogen activator（t-PA） fiber changes in plasminogen activator inhibitor（ PAI-1 ） and platelet count（PT） of the 2 groups were detected and compared. Results After surgery, D-D, t- PA, PAI-1 increased significantly, PT, AFTT prolonged, TT shortened and PLT decreased. D-D ,t-PA ,PAI-1 and APTT in the study group were lower than those of the control group, and TT ,PLT in the study group were higher than those of the control group, there had statistical difference （P 〈 0.05 ）. Expect PLT, the group x time interaction of other indicators were significantly different （P 〈 0.05 ）. The incidence of DVT in the control group was 25.0% （ 10/40）, higher than 12.5 % （5/40） of the study group, but there had no statistical difference （ χ^2 = 2.051, P = 0.152）. Conclusion The blood is in hypercoagulable state in patients with colorectal cancer after operation, which easily leads to deep vein thrombosis;hemocoagulase can aggravate the hypercoagulable state, and it is proper to reduce the use of hemocoagulase after colon cancer surgery.