低分子肝素联合阿司匹林预防腹腔镜胃癌根治术后患者下肢深静脉血栓形成的效果

Effect of low molecular weight heparin combined with aspirin in preventing deep venous thrombosis of lower extremity in patients after laparoscopic radical gastrectomy

目的观察低分子肝素联合阿司匹林预防腹腔镜胃癌根治术后患者下肢深静脉血栓(DVT)形成的效果。方法将我院行腹腔镜胃癌根治术的82例患者随机分为对照组(n=41)和观察组(n=41),给予对照组皮下注射低分子肝素,观察组在对照组基础上联合阿司匹林栓经直肠给药。比较两组患者术后DVT发生率、不同时间凝血功能及血小板功能。结果术后7d,观察组DVT发生率为2.44%,显著低于对照组的17.07%(P<0.05)。术后7d,两组APTT、PT均长于用药前,且观察组长于对照组(P<0.05)。术后7d,观察组血小板最大聚集率低于对照组及用药前,差异有统计学意义(P<0.05)。结论低分子肝素联合阿司匹林栓经直肠给药能明显改善腹腔镜胃癌根治术后患者血液高凝状态、降低血小板功能,有效减少深静脉血栓发生,是预防腹腔镜胃癌根治术后患者深静脉血栓形成的有效方法。

Objective To observe the effect of low molecular weight heparin combined with aspirin in preventing deep venous thrombosis (DVT) of lower extremity in patients after laparoscopic radical gastrectomy. Methods A total of 82 patients who underwent laparoscopic radical gastrectomy in our hospital were randomly divided into control group (n=41) and observation group (n=41). The control group was given subcutaneous injection of low molecular weight heparin, while the observation group was given aspirin suppository via rectum on the basis of the control group. The incidence of DVT, coagulation function and platelet function at different time were compared between the two groups. Results On the 7th day after operation, the incidence of DVT in the observation group was 2.44%, which was significantly lower than 17.07% in the control group (P<0.05). On the 7th day after operation, the APTT and PT in both groups were longer than those before treatment, and those in the observation group were longer than the control group (P<0.05). On the 7th day after operation, the maximum platelet aggregation rate in the observation group was lower than that in the control group and before treatment, and the differences were statistically significant (P<0.05). Conclusion Low molecular weight heparin combined with aspirin suppository via rectum can significantly improve blood hypercoagulability, and reduce platelet function and incidence of DVT in patients after laparoscopic radical gastrectomy. It is an effective method to prevent DVT in patients after laparoscopic radical gastrectomy.