低分子肝素抗凝预防非小细胞肺癌患者胸腔镜术后发生静脉血栓栓塞症的效果

The effect of low molecular weight heparin anticoagulation on preventing venous thromboembolism in patients with non-small cell lung cancer after thoracoscopy

目的探讨非小细胞肺癌(NSCLC)患者行胸腔镜术后应用低分子肝素抗凝预防静脉血栓栓塞症(VTE)发生的效果。方法选择2018年1月至2021年1月在嘉兴市第一医院接受胸腔镜手术治疗的NSCLC患者327例,术前均常规行下肢多普勒血管超声及胸部增强CT检查已排除术前合并VTE,低分子肝素抗凝组86例,非抗凝组296例,倾向匹配产生80对,结合术前临床特征,比较低分子肝素抗凝预防血栓的疗效及安全性。结果抗凝组患者术后的血浆D-二聚体水平、VTE发生率均明显低于非抗凝组,抗凝组的住院时间短于非抗凝组,差异均有统计学意义(P<0.05)。两组的术后引流量、出血并发症发生情况比较,差异均无统计学意义(P>0.05)。结论NSCLC患者胸腔镜术后予以低分子肝素预防抗凝治疗能够有效降低术后VTE的发生率,缩短了住院时间,且并未增加术后出血风险。

Objective To investigate the effect of low molecular weight heparin on prevention of venous thromboembolism(VTE)in patients with non-small cell lung cancer(NSCLC)after thoracoscopic surgery.Methods A total of 327 NSCLC patients who received thoracoscopic surgery in the First Hospital of Jiaxing city from January 2018 to January 2021 were selected.Preoperative VTE was excluded by routine lower limb Doppler ultrasound and chest enhanced CT examination.There were 86 patients in the low-molecular weight heparin anticoagulant group and 296 patients in the nonanticoagulant group,and 80 pairs of patients were generated by tendency matching.Combined with preoperative clinical features,the efficacy and safety of low molecular weight heparin in anticoagulant prevention of thrombosis were compared.Results The plasma D-dimer level and the incidence of VTE in the anticoagulant group were significantly lower than those in the non-anticoagulant group,and the hospital stay in the anticoagulant group was shorter than that in the non-anticoagulant group,with statistical significance(P<0.05).There were no significant differences in postoperative drainage and bleeding complications between the two groups(P>0.05).Conclusion Prophylaxis and anticoagulant therapy with low-molecular weight heparin after thoracoscopic surgery in NSCLC patients can effectively reduce the incidence of postoperative VTE,shorten the length of hospital stay,and do not increase the risk of postoperative bleeding.