肺叶切除术后早期使用低相对分子质量肝素预防肺血栓栓塞

摘要

目的：探讨肺叶切除术后早期使用低相对分子质量肝素( LMWH)预防肺血栓栓塞症( PTE)的疗效及安全性。方法选取96例肺癌患者,均行肺叶切除术治疗,进行完全随机化分组(抗凝组与对照组)；抗凝组( n=48)术后12 h内使用LMWH抗凝治疗,腹壁皮下注射7500~10000 AXaICU,1次/d,疗程10 d；对照组(n=48)不使用LMWH治疗；监测及对比分析两组患者术后血性胸水引流量( HCWF)、PT、aPTT、PLT及Fbg。结果抗凝组术后第一天、第二天、第三天及第四天的HCWF与对照组对比,均无统计学差异(P>0．05)；抗凝组术后PT、aPTT、PLT及Fbg与对照组对比,均具有统计学差异(P<0．05)。结论肺叶切除术后早期使用LMWH抗凝对于预防PTE发生的疗效显著,不增加术后出血的风险,治疗安全性高,具有临床可行性。%Objective To study the early use of low molecular weight heparin( LWMH) after lung re-section anticoagulant efficacy and safety of preventing pulmonary thromboembolism( PTE). Methods Choose 96 cases of patients with lung cancer,lung resection treatment,to completely randomized grouping( anticoagu-lant group and control group);Anticoagulant group(n=48)within 12 h after using LMWH anticoagulation,ab-dominal subcutaneous injection of 7 500~10000 axaicu,1 time/day,10 day/treatment;The control group( n=48 ) does not use LWMH treatment;Monitoring and analysis of two groups of patients with postoperative Hemor-rhagic chest water flow(HCWF),PT,aPTT,PLT and Fbg. Results Postoperative anticoagulation group,on the first day,the second day,the third and fourth days HCWF compared with control group,there were no sta-tistical differences(P>0. 05);Postoperative anticoagulation group PT,aPTT,PLT and Fbg compared with con-trol group,were statistically difference(P<0. 05). Conclusion After lung resection early use LMWH antico-agulation prevention PTE curative effect is distinct,without increasing the risk of postoperative bleeding,treat-ment of high security,have clinical feasibility.