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目的:探讨乳腺癌术后腋下组织肌间静脉血栓的形成及治疗方法。方法:以本院普通外科2011年1月至2014年1月收治的32例行乳腺癌根治术后发生腋下组织肌间静脉血栓患者作为观察组,同期行相同手术治疗未发生静脉血栓的患者作为对照组,比较两组患者的血流动力学、凝血指标差异;在对观察组患者采用抗凝及溶栓治疗10 d后再对两组患者的血流动力学、凝血指标进行比较。结果:观察组治疗前的彩色多普勒检测指标PSV为(34.6±12.9)cm·s~(-1)、EDV为(12.7±5.3)cm·s~(-1)、TAMAX为(19.8±8.4)cm·s~(-1),均显著低于对照组(P<0.05);观察组治疗前的PI、RI值与对照组比较差异无统计学意义(P>0.05)。观察组治疗前的APTT为(23.1±3.9)s、PT为(11.8±2.3)s,显著低于对照组(P<0.05);观察组治疗前的FIB为(4.3±0.7)g·L~(-1)、DD为(351.6±98.9)μg·L~(-1),显著高于对照组(P<0.05)。治疗后观察组患者的PSV、EDV、TAMAX值较治疗前均显著提高(P<0.05);治疗后的PI、RI值较治疗前降低但差异无统计学意义(P>0.05)。治疗后观察组患者的APTT、PT值较治疗前均显著提高(P<0.05);治疗后的Fib、DD值较治疗前降低且差异具有统计学意义(P<0.05)。结论:乳腺癌手术后患者血液高凝状态是发生静脉血栓的主要原因,积极采取抗凝、溶栓治疗能够取得较好的临床效果。
Objective: To investigate the formation and treatment of intramuscular venous thrombus in the axillary tissue after breast cancer surgery. METHODS: Thirty-two patients with myasthenia gravis myenteric vein thrombosis who underwent radical mastectomy from January 2011 to January 2014 in our hospital were selected as the observation group. Patients underwent the same operation in the same period without venous thrombosis As a control group, the differences of hemodynamics and coagulation index between the two groups were compared. After comparing the observation group’s patients with anticoagulation and thrombolysis for 10 days, the hemodynamics and coagulation indexes of the two groups were compared. Results: The PSV of the observation group before treatment was (34.6 ± 12.9) cm · s -1, EDV was (12.7 ± 5.3) cm · s -1 and TAMAX was (19.8 ± 8.4) cm · s ~ (-1), which were significantly lower than those of the control group (P <0.05). There was no significant difference in the PI and RI between the observation group and the control group before treatment (P> 0.05). The APTT before treatment in observation group was (23.1 ± 3.9) s, PT was (11.8 ± 2.3) s, which was significantly lower than that in control group (P <0.05). The FIB in observation group before treatment was (4.3 ± 0.7) (-1), DD was (351.6 ± 98.9) μg · L -1, which was significantly higher than that of the control group (P <0.05). After treatment, PSV, EDV and TAMAX in observation group were significantly higher than those before treatment (P <0.05). PI and RI in treatment group were lower than those before treatment, but there was no significant difference (P> 0.05). After treatment, the APTT and PT of the observation group were significantly higher than those before treatment (P <0.05). The Fib and DD values of the observation group were significantly lower than those before treatment (P <0.05). Conclusion: The hypercoagulability of blood in patients with breast cancer is the main cause of venous thrombosis. Active anticoagulant and thrombolytic therapy can achieve better clinical results.