药物结合物理疗法在胸腔镜肺癌根治术后患者静脉血栓栓塞症预防中的应用效果

Effect of drug combined with physical therapy in the prevention of venous thromboembolism after thoracoscopic radical resection of lung cancer

目的探讨药物结合物理疗法在胸腔镜肺癌根治术后患者静脉血栓栓塞症预防中的应用效果。方法选取2016年1月至2020年12月福建医科大学附属第二医院300例胸腔镜肺癌根治术后患者作为研究对象,根据随机数字表法分成联合组(n=150)和物理组(n=150)。物理组采用物理预防,联合组在物理组的基础上使用药物预防。比较两组患者治疗前后血液相关指标[血红蛋白(Hb)、D-二聚体、纤维蛋白原(FIB)]变化及静脉血栓栓塞症、出血发生率。结果两组患者的胸管引流量、胸管滞留时间比较,差异无统计学意义(P>0.05)。联合组的术后住院时间短于物理组,差异有统计学意义(P<0.05)。两组患者治疗后的Hb水平比较,差异无统计学意义(P>0.05)。联合组治疗后的D-二聚体、FIB水平低于物理组,差异有统计学意义(P<0.05)。联合组的静脉血栓栓塞症总发生率低于物理组,差异有统计学意义(P<0.05)。两组患者的出血发生率比较,差异无统计学意义(P>0.05)。结论采取药物预防结合物理预防可以降低胸腔镜肺癌根治术后患者的静脉血栓栓塞症发生率,并缩短术后住院时间,且不增加术后引流量,不延长胸管滞留时间,安全性好,可作为肺癌术后预防静脉血栓栓塞症的重要措施。

Objective To explore the effect of drug combined with physical therapy in the prevention of venous thromboembolism after thoracoscopic radical resection of lung cancer.Methods A total of 300 patients after thoracoscopic radical resection of lung cancer in the Second Affiliated Hospital of Fujian Medical University from January 2016 to December 2020 were selected as the research objects.According to the random number table method,they were divided into combined group(n=150)and physical group(n=150).The physical group used physical prevention,and the combined group used drug prevention on the basis of the physical group.The changes of blood related indexes(hemoglobin[Hb],D-dimer,fibrinogen[FIB])before and after treatment and the incidence of venous thromboembolism and bleeding were compared between the two groups.Results There were no significant differences between the two groups in chest tube drainage volume and chest tube retention time(P>0.05).The postoperative hospital stay in the combined group was shorter than that in the physical group,and the difference was statistically significant(P<0.05).There was no significant difference in Hb level between the two groups after treatment(P>0.05).The levels of D-dimer and FIB in the combined group were lower than the physical group,the differences were statistically significant(P<0.05).The total incidence of venous thromboembolism was lower than the physical group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of bleeding between the two groups(P>0.05).Conclusion Drug combined with physical therapy can reduce the incidence of venous thromboembolism in patients with radical thoracoscopic pulmonary cancer and shorten the postoperative hospitalization time,do not increase postoperative flow and prolong the retention of thoracic tube,which can serve as an important measure to prevent pulmonary cancer.