预防肺癌术后血栓栓塞事件的围手术期处置方案

Scheme for prevention of thromboembolism in peri-operative period of lung cancer surgery

目的探讨预防肺癌患者术后血栓栓塞事件发生的围手术期处置方案。方法实施新围手术期处置方案的肺癌切除术患者402例作为研究组,新方案主要包括深静脉置管建立输液途径,术后不用止、凝血药物,预防性应用抗凝药物,预防性使用弹力袜等。未实施新围手术期处置方案的356例肺癌切除术患者作为对照组。比较两组术后下肢深静脉血栓和肺栓塞及出血相关性并发症的发生率。结果研究组血栓栓塞事件发生率(1.49%)显著低于对照组(9.27%,χ2=34.286,P=0.000),下肢深静脉血栓和肺栓塞的发生率(1.24%,0.25%)均分别显著低于对照组(5.90%,3.37%)(χ2=19.386,P=0.000;χ2=12.469,P=0.001)。两组并发症情况对比无显著差异(P>0.05)。结论围手术期新方案对预防肺癌术后血栓栓塞事件的发生是安全有效的措施。

Objective To discuss the scheme for prevention of thromboembolism in peri-operative period of lung cancer surgery. Methods 402 cases of lung cancer surgery were selected as experiment group to be treated with the new peri-operative scheme which included deep vein catheterization for infusion, no administration of hemostatic, preventive application of anticoagulants and elastic socks ; other 356 cases of lung cancer surgery were selected as control group, to whom the new peri-operative scheme was not applied. A comparative study was made to the occurrence of deep vein thrombosis of lower extremity, pulmonary embolism and other related complications between the 2 groups. Results The occurrence of thromboembolism in experiment group （ 1.49% ） was obviously lower than that in control group（9.27% ） 0（2 = 34. 286, P = 0. 000 ） ; the occurrences of deep vein thrombosis of lower extremity and pulmonary embolism in experiment group （ 1.24% ; 0.25 % ） were lower than those in control group （5.90% ; 3.37 % ） （X^2 = 19. 386, P = 0. 000 ;X^2 = 12. 469,P = 0.001 ）. No difference in the occurrence of complications was found between the 2 groups （ P 〉 0.05 ）. Conclusions The application of the new scheme is safe and effective in preventing the occurrence of thromboembolism in peri- operative period of lung cancer surgery.