食管癌术后应用低分子肝素钙预防深静脉血栓形成

Application of low molecular heparin calcium in the prevention after esophageal cancer for patients with deep vein thrombosis

目的:探讨低分子肝素钙预防食管癌术后深静脉血栓的临床价值。方法:选取食管癌患者180例,根据术后是否应用低分子肝素钙随机分为治疗组和对照组。分别在治疗前后比较两组患者组织型血浆酶原激活剂(t-PA)、血浆酶原激活物抑制剂(PAI)、纤维蛋白原(FIB)及D-二聚体(D-D)的差异,观察有无发生深静脉血栓(DVT)及术后出血等不良反应,并对DVT患者进行危险因素分析。结果:对照组、治疗组术后PAI、FIB以及D-D水平均较术前低,t-PA水平较术前高;治疗组术后PAI、FIB以及D-D水平均较对照组术后低,t-PA水平较对照组高,以上差异均有统计学意义(分别P<0.05及P<0.01)。治疗组DVT、肺栓塞、心肌梗死发生率低于对照组,差异有统计学意义(P<0.05);心源性猝死和术后出血发生率两组差异无统计学意义(P>0.05)。既往冠心病、下肢静脉曲张、肥胖以及年龄>65岁是导致食管癌术后易患DVT的独立危险因素(P<0.05)。结论:早期应用低分子肝素钙对于预防食管癌术后伴发DVT安全且疗效肯定。

Objective：To evaluate the effect of low molecular heparin calcium to prevent esophageal cancer on postoperative deep vein thrombosis. Methods：Select 180 cases of esophageal cancer patients,according to whether the postoperative application of low molecular heparin calcium divided into treatment group and control group. To observe organization type plasma enzyme original activator（t - PA）and plasma enzyme activation inhibitor（PAI）,fibrinogen （FIB）and D - dimer（D - D）,deep vein thrombosis（DVT）,hemorrhage and other adverse reactions. Results：Post-operative PAI,FIB and control group,treatment group D - D levels were relatively low preoperative,t - PA level com-pared with preoperative high. Treatment group after PAI,FIB and D - D levels lower than the control group,postopera-tive low t - PA level higher than control group（P ﹤ 0. 05 and P ﹤ 0. 01）. Treatment group DVT,pulmonary embolism, myocardial infarction incidence was lower than the control group（P ﹤ 0. 05）. Sudden cardiac death and the incidence of postoperative bleeding had no statistically significant differences between the two groups（P ﹥ 0. 05）. Conclusion：Early application of low molecular heparin calcium to prevent after esophagectomy with DVT is safe and effective.