低分子肝素钠对行PICC置管的小细胞肺癌患者静脉血栓的预防研究

The thrombosis prevention effect of low-molecular heparin on small cell lung cancer patients with PICC

目的:探讨与普通肝素相比低分子肝素钠对行PICC置管的小细胞肺癌患者静脉血栓的预防效果。方法:选择符合纳入标准的患者180例,采用随机数字法将患者分为普通肝素组(n=91)和低分子肝素组(n=89)。低分子肝素钠组在置管时将导管用低分子肝素钠浸泡10 min再植入,输液后及维护期间均给予低分子肝素钠盐水溶液正压封管;普通肝素钠组在置管时则用普通肝素钠浸泡且在输液后及维护期间给予肝素钠盐水溶液正压封管,然后比较置管前和置管6周后患者的实验室指标、临床指标以及两组患者6周后血栓的发生率。结果:两种药物对血小板计数(PLT)、血浆纤维蛋白原(FIB)值的减少有意义(P<0.05),但对血液D-二聚体的降低则没有影响(P>0.05),且二者对凝血功能的影响没有差别(P>0.05);但低分子肝素与普通肝素相比在出血率、堵管率、PLT减少率、血栓发生率存在差异,且有统计学意义(P<0.05)。结论:与普通肝素相比低分子肝素钠对行PICC置管的小细胞肺癌患者静脉血栓的预防更有优势,可以在临床推广。

Objective：To evaluate the thrombosis prevention effect of low-molecular heparin on small cell lung cancer patients with PICC compared with heparin. Methods ：180 patients conformed to the standard were randomly assigned to lowmolecular heparin group（ n = 91 ） or heparin group（ n = 89 ）. Before having PICC intubation, the low-molecular heparin group immersed in the catheter in the solution of low-molecular heparin as long as 10 minutes, However the heparin group immersed in the solution of hcparin. After the infusion or during the maintenance period, the low-molecular heparin group used low-molecular heparin, and the low-molecular heparin group used heparin. And compared with the laboratory indexes and clinical indexes of patients before PICC intubation and 6 weeks after it, and compared with the rate of thrombosis of the two groups after 6 weeks. Results：There were significant differences in the reduction of platelet count （PLT） , plasma fibrinogen （FIB） of the two groups （P 〈 0.05 ）, but the reduction of the D-dimer and the influence on blood coagulation function were no significant differences （ P 〉 0.05 ） ; There were significant differences in the hemorrhage rate, rate of blocking pipe, PLT decrement, rate of thrombosis of the two groups （ P 〈 0.05 ）. Conclusion： The thrombosis prevention effect of low-molecular heparin on small cell lung cancer patients with PICC is better than heparin,it can replace the ordinary heparin in clinical practice.