肝癌切除术后检测D-二聚体及纤维蛋白原降解产物变化对深静脉血栓形成预防意义研究

Investigation on that prevention of deep venous thrombosis in d-dimer and fibrinogen degradation product after hepatectomy

目的:探讨肝癌切除术后患者D-二聚体(D-Di)及纤维蛋白原降解产物(FDP)的变化与深静脉血栓形成(DVT)的关系,以指导DVT的防治。方法:回顾性分析381例手术切除的肝癌患者,对发生DVT的7例(A组)及符合入组条件、未发生DVT的68例(B组)的D-Di及FDP术前、术后变化进行研究分析。结果:两组患者术后D-Di及FDP值均较术前升高。两组的D-Di值在术后第1、3、5天均持续升高,但B组升高的幅度低于A组的半数。A组的FDP值术后第1、3、5天持续升高;B组的FDP在术后第1天达到高峰,之后开始波动式下降。两组FDP的组间、时点间的效应差异及组间时点间的交互效应差异均无统计学意义(P>0.05),而两组D-Di的组间、时点间的效应差异及组间时点间的交互效应差异均有统计学意义(P<0.01)。结论:肝癌切除术后若DDi及FDP呈持续上升态势,要高度警惕DVT发生。快速康复外科(ERAS)治疗有利于深静脉血栓的预防。

Objective:To investigate the relationship between d-dimer(D-Di)&fibrinogen degradation products(FDP)and Deep Vein Thrombosis(DVT)after hepatectomy,to guide the prevention and treatment of DVT.Methods:Retrospective analysis was conducted on 381 cases patients of resection of liver cancer and analyzed the changes of D-Di and FDP preoperative and postoperative of which 7 cases of DVT patients and comply with the group,68 cases of no DVT patients.Results:The values of d-di and FDP were higher in both groups after surgery.The D-Di values of the two groups continued to rise postoperative 1,3,5 d,but the increase of group B was less than half of group A.The FDP value in group A continued to increase postoperative 1,3,5 d;but the FDP in group B reached its peak on the first day after surgery,and then began to decrease in fluctuation.There were no statistical significance between the two groups,time point and on the interaction effect of groups·time piont of FDP(P>0.05),but there were statistically significant differences between the two groups,time point and on the interaction effect of groups·time piont of D-Di(P<0.01).Conclusion:After hepatectomy,if D-Di and FDP showed a continuous uptrend,the DVT should be highly vigilant.Enhanced recovery after surgery is beneficial to the prevention of deep vein thrombosis.