低分子肝素对肺癌患者术后住院期间下肢深静脉血栓形成的影响

Effect of low molecular weight heparin on lower extremity deep venous thrombosis in lung cancer patients during postoperative hospitalization

目的探讨低分子肝素对肺癌患者术后住院期间下肢深静脉血栓形成(DVT)的影响。方法收集2020年1月至2023年6月于河北承德医学院附属医院接受外科手术治疗的156例肺癌患者的临床资料,将2021年12月之前未使用低分子肝素预防下肢DVT的患者作为对照组(n=81),将2022年1月开始使用低分子肝素预防下肢DVT的患者作为干预组(n=75)。比较两组患者的手术相关指标、住院期间下肢DVT发生情况、出院之前凝血功能指标及住院期间其他并发症的发生情况。结果两组患者的肿瘤部位、肿瘤分型、手术时间、术中低体温比例、术中出血量、使用呼吸机情况、间歇性气压治疗情况及使用足底静脉泵情况比较,差异均无统计学意义(P﹥0.05)。住院期间共13例患者发生下肢DVT,其中,干预组患者下肢DVT的发生率低于对照组患者,差异有统计学意义(P﹤0.05)。住院期间共有49例患者发生了除下肢DVT之外的其他并发症,两组患者其他并发症的发生率比较,差异无统计学意义(P﹥0.05)。出院之前化验结果显示,两组患者的凝血酶原时间、活化部分凝血活酶时间比较,差异均无统计学意义(P﹥0.05)。结论低分子肝素可有效降低肺癌手术患者住院期间发生下肢DVT的风险,且不会对患者的凝血酶原时间和活化部分凝血活酶时间造成明显的影响,亦不会增加并发症,值得临床推广。

Objective To investigate the effect of low molecular weight heparin on lower extremity deep venous thrombosis(DVT)in lung cancer patients during postoperative hospitalization.Method The clinical data of 156 cases lung cancer patients who underwent surgical treatment at the Affiliated Hospital of Chengde Medical College from January 2020 to June 2023 were collected,the patients who did not use low molecular weight heparin to prevent lower extremity DVT before December 2021 were selected as the control group(n=81),while the patients who started using low molecular weight heparin to prevent lower extremity DVT in January 2022 were selected as the intervention group(n=75).The surgical related indicators,incidence of lower extremity DVT during hospitalization,coagulation function indicators before discharge,and incidence of other complications during hospitalization between two groups of patients were compared.Result There was no statistically significant difference between the two groups of patients in tumor location,tumor classification,surgical time,proportion of intraoperative hypothermia,intraoperative bleeding,use of respirator,intermittent pneumatic therapy,and use of plantar venous pumps(P>0.05).During hospitalization,13 patients experienced lower extremity DVT.Among them,the incidence of lower extremity DVT in the intervention group was lower than that of control group,and the difference was statistically significant(P<0.05).During hospitalization,49 patients experienced complications other than the lower extremity DVT,there was no statistically significant difference in the incidence of other complications between the two groups of patients(P>0.05).The laboratory test results before discharge showed that there was no statistically significant difference in the prothrombin time and activated partial thromboplastin time between the two groups of patients(P>0.05).Conclusion Low molecular weight heparin can effectively reduce the risk of lower extremity DVT in lung cancer patients during postoperative hospitalization,while not affecting the patient's prothrombin time and activated partial thromboplastin time and not increasing the risk of complications.It is worthy of clinical promotion.