低分子肝素在D-二聚体增高晚期肿瘤患者中临床应用研究

Research of clinical application of low molecular weight heparin in advanced tumor patients with increased D-dimer

目的观察低分子肝素治疗晚期肿瘤患者D-二聚体增高的疗效。方法检测28例晚期肿瘤患者的血凝及血小板结果，并对血栓标志物D-二聚体增高的患者行低分子肝素皮下注射，每12小时注射1次，治疗7～10d。检测治疗后相关指标。结果治疗后，D-二聚体水平、纤维蛋白原（Fib）水平低于治疗前，差异有统计学意义（P〈0．01）；而患者凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、血小板（PLT）结果与治疗前比较差异无统计学意义（P〉0．05）。随访3～20个月，均无血栓疾病发生。结论应用低分子肝素能改善晚期肿瘤患者高凝状态，无出血及其他不良反应，可常规临床应用于晚期肿瘤预防血栓形成。

Objective To observe curative effect of low molecular weight heparin in the treatment of advanced tumor patients with increased D-dimer. Methods Blood coagulation and blood platelet were detected in 28 patients with advanced tumor. Those with increased D-direct as thrombosis marker received subcutaneous injection of low molecular weight heparin once in every 12 h for 7-10 d. Related indexes were detected after treatment. Results After treatment, D-dimer and fibrinogen （Fib） levels were lower than those before treatment, and the difference had statistical significance （P〈0.01）, while there was no statistically significant difference of prothrombin time （PT）, activated partial thromboplastin time （APTT） and platelets （PLT） in patients （P〉0.05）. Follow-up for 3~20 months showed no occurrence of thrombosis. Conclusion Application of low molecular weight heparin can improve hypercoagulable state in advanced tumor patients, without hemorrhage or other adverse reactions. This method can be used as conventional clinical prevention measure for thrombosis in advanced tumor.