那曲肝素钙对预防妇科肿瘤腹腔镜术后深静脉血栓的意义

Significance of Nadroparin Calcium in the Prevention of Deep Venous Thrombosis after Laparoscopic Surgery for Gynecological Oncology

目的分析那曲肝素钙用于预防妇科肿瘤患者腹腔镜手术后深静脉血栓(deep venous thrombosis,DVT)的意义。方法方便选取2021年1—12月在贵州医科大学附属肿瘤医院开展腹腔镜手术的78例妇科肿瘤患者进行研究,采用随机数表法分为对照组(术后采取常规方式进行干预)和观察组(除对照组干预措施之外加以那曲肝素钙),分别包含39例,统计并比较两组术后DVT发生率;术前1 d及术后7 d的血小板计数(PLT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)以及D-二聚体(D-D)水平;术前1 d及术后7 d的下肢周径差和卡式功能状态量表(KPS)得分情况。结果观察组的DVT发生率为2.56%,低于对照组20.51%,差异有统计学意义(χ^(2)=4.522,P<0.05)。术前1 d,两组PLT、TT、PT、APTT、FIB、D-D水平相比,差异无统计学意义(P>0.05);术后7 d,两组PLT、TT、PT、APTT水平相比,差异无统计学意义(P>0.05),观察组FIB、D-D水平低于对照组,差异有统计学意义(P<0.05)。术前1 d,两组下肢周径差及KPS得分相比,差异无统计学意义(P>0.05);术后7 d,观察组的下肢周径差低于对照组,KPS得分高于对照组,差异有统计学意义(P<0.05)。结论那曲肝素钙用于预防妇科肿瘤患者腹腔镜手术后DVT效果理想,能促进下肢血液循环,改善凝血指标及机体功能状态。

Objective To analyze the significance of nadroparin calcium for the prevention of deep venous thrombosis(DVT)after laparoscopic surgery in gynecologic oncology patients.Methods Seventy-eight gynecologic tumor patients who underwent laparoscopic surgery in the Affiliated Cancer Hospital of Guizhou Medical University from January to December 2021 were selected for the study.The random number table method was used to divide the patients into a control group(postoperative intervention by conventional means)and an observation group(addition of nadroparin calcium in addition to the interventions in the control group),containing 39 cases respectively.The incidence of postoperative DVT,platelet count(PLT),prothrombin time(TT),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB)and D-dimer(D-D)levels,lower limb circumference difference and cardinal functional status scale(KPS)scores at 1 d before and 7 d after surgery were counted and compared between the two groups.Results The incidence of DVT in the observation group was 2.56%lower than that in the control group,which was 20.51%.,and the difference was statistically significant(χ^(2)=4.522,P<0.05).There was no significant difference in PLT,TT,PT,APTT,FIB,and D-D levels between the two groups at 1 d preoperatively(P>0.05).At 7 d postoperatively,there was no significant difference in PLT,TT,PT,and APTT levels compared between the two groups(P>0.05),the levels of FIB and D-D in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).At 1 d before surgery,there was no significant difference in lower limb circumference difference and KPS score compared with the two groups(P>0.05).At 7 d postoperatively,the lower limb circumference difference in the observation group was lower than that in the control group,and the KPS score was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of nadroparin calcium for the prevention of DVT after laparoscopic surgery in gynecological tumor patients is ideal,and it can promote blood circulation in the lower limbs and improve coagulation index and functional status of the body.