低分子肝素对结直肠癌患者术后静脉血栓栓塞的治疗效果观察

Observation on the therapeutic effect of low molecular weight heparin on postoperative venous thromboembolism in patients with colorectal cancer

目的观察低分子肝素对结直肠癌患者术后静脉血栓栓塞(VTE)的治疗效果。方法收集2016年1月至2023年1月于首都医科大学附属北京天坛医院收治的72例结直肠癌术后发生VTE的患者的临床资料,根据治疗方法的不同将患者分为常规组(接受常规治疗)和观察组(在常规治疗的基础上接受低分子肝素治疗),每组36例。比较两组患者的手术相关指标,包括手术时间、术中出血量、下床活动时间、总住院时间。比较两组患者治疗前(确诊VTE时)、治疗后(治疗14 d后)的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、D-二聚体(D-D)水平]和下肢静脉系统的平均血流速度。结果观察组患者的下床活动时间、总住院时间均明显短于常规组患者,差异均有统计学意义(P﹤0.01)。治疗后,观察组患者的PT、APTT均长于常规组患者,FIB、D-D水平均低于常规组患者,差异均有统计学意义(P﹤0.05)。治疗后,观察组患者股总静脉、股深静脉、股浅静脉、胫后静脉、胫前静脉的平均血流速度均快于常规组患者,差异均有统计学意义(P﹤0.05)。结论低分子肝素能够提高对结直肠癌患者术后VTE的治疗效果,提高患者下肢静脉血流速度,改善患者的凝血功能。

Objective To observe the therapeutic effect of low molecular weight heparin on postoperative venous thromboembolism(VTE)in patients with colorectal cancer.Method The clinical data of 72 patients with VTE after colorectal cancer surgery who were admitted to Beijing Tiantan Hospital,Capital Medical University from January 2016 to January 2023 were collected.According to different treatment methods,the patients were divided into routine group(receiving conventional treatment)and observation group(receiving low-molecular-weight heparin therapy based on conventional treatment),with 36 cases in each group.The operation-related indicators,including operation time,intraoperative blood loss,time of getting out of bed,and total hospitalization time,of the two groups of patients were compared.The coagulation function indexes prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)and the average blood flow velocity of the lower extremity venous system were also compared between the two groups before treatment(when VTE was diagnosed)and after treatment(after 14 days of treatment).Result The time of getting out of bed and the total hospitalization time of the patients in the observation group were significantly shorter than those in the routine group,and the differences were statistically significant(P<0.01).After the treatment,the PT and APTT of the observation group were longer than those of the routine group,the FIB and D-D levels were lower than those of the routine group,and the differences were statistically significant(P<0.05).After the treatment,the average blood flow velocity of the common femoral vein,deep femoral vein,superficial femoral vein,posterior tibial vein,and anterior tibial vein were faster than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion Low molecular weight heparin could improve the therapeutic effect on postoperative VTE in patients with colorectal cancer,increase the venous blood flow velocity of the lower extremity,and improve the coagulation function of patients.