基于Caprini风险评估的快速康复外科对胸腔镜肺癌切除术后患者围手术期高凝状态及静脉血栓栓塞症的预防作用

Preventive effect of fast rehabilitation surgery based on Caprini risk assessment on patients with perioperative hypercoagulability and venous thromboembolism after thoracoscopic lung cancer resection

目的 分析基于Caprini风险评估的快速康复外科对胸腔镜肺癌切除术后患者围手术期高凝状态及静脉血栓栓塞症的预防作用。方法 我院收治的156例胸腔镜肺癌切除术后患者,采用随机数字表法分为研究组和对照组各78例,对照组给予快速康复外科干预,研究组在进行Caprini风险评估分级之后,给予针对性的快速康复外科干预。比较两组术前及术后7 d血液学指标血红蛋白(Hb)、血小板(PLT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及D-二聚体(D-Dimer)水平,比较两组胸腔引流量、胸管留置时间、住院时间、静脉血栓栓塞症(VTE)发生率及血栓最大宽度。结果 研究组术后7 d PLT、APTT、D-Dimer、TT低于对照组,胸腔引流量、胸管留置时间、住院时间少于对照组。VTE发生率及血栓最大宽度低于对照组(P<0.05)。结论 基于Caprini风险评估的快速康复外科更有利于改善胸腔镜肺癌切除患者围手术期凝血功能,降低了VTE的发生,适合在临床推广应用。

Objective To analyze the preventive effect of fast recovery surgery based on Caprini risk assessment on perioperative hypercoagulability and venous thromboembolism in patients after thoracoscopic lung cancer resection.Methods A total of 156 patients after thoracoscopic lung cancer resection in our hospital were selected. The patients were divided into a study group and a control group by random number table method, 78 in each group. The patients in the two groups underwent thoracoscopic lung cancer resection by the same group of physicians. After surgery, the control group was given fast rehabilitation surgery intervention. The study group was given Caprini risk assessment. After grading, targeted surgical intervention for rapid recovery surgery was given. The hematological indexes such as hemoglobin(Hb), platelet(PLT), activated partial thromboplastin time(APTT), thrombin time(TT) and D-dimer(D-Dimer) were compared before operation and after 7 days of operation between the two groups. The thoracic drainage volume, chest tube indwelling time, and hospitalization time as well as the incidence of venous thromboembolism(VTE) and the maximum width of thrombus were compared between the two groups.Results The PLT, APTT, D-Dimer and TT after 7 days of operation in the study group were lower than those in the control group. The thoracic drainage volume, chest tube indwelling time and hospital stay in the study group were less or shorter than those in the control group. The incidence of VTE and the maximum width of thrombus in the study group were lower or smaller than those in the control group. All differences were statistically significant(P<0.05).Conclusion Fast recovery surgery based on Caprini risk assessment is more conducive to improving the perioperative coagulation function in patients with thoracoscopic lung cancer resection, and reducing the occurrence of VTE. This is suitable for clinical application.