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目的探讨进展期胃癌病人联合脾、胰体尾切除治疗术后静脉血栓形成的预防。方法选择进展期胃癌并接受根治性联合脾、胰体尾切除手术治疗的病人(治疗组)16例,动态监测围手术期血小板计数的变化规律,术后行预防性静脉血栓形成的治疗。回顾分析接受相同手术治疗病人(对照组)13例,未系统进行预防静脉血栓形成治疗。结果治疗组病人术后第1天血小板和术前比较明显下降(P<0.01),至第3天回升到术前水平,然后持续上升,至第5天明显高于术前(P<0.01),至第10~15天维持其高峰状态,然后逐渐下降,至第30天降至术前水平,治疗组中无一例发生静脉血栓。对照组病人术后发生下肢静脉血栓3例,发生率为23%。结论联合脾、胰体尾切除治疗进展期胃癌病人术后1个月内要严密监测血小板计数变化,并根据血小板变化规律及时进行抗凝治疗,预防术后病人静脉血栓形成。
Objective To investigate the prevention of postoperative venous thrombosis in patients with advanced gastric cancer combined with splenic and pancreatic body tail resection. Methods Sixteen patients with advanced gastric cancer who underwent radical resection combined with splenic and pancreatic body tail resection were selected. The changes of perioperative platelet counts were dynamically monitored and prophylactic venous thrombosis was performed after operation. Retrospective analysis of 13 patients receiving the same surgical treatment (control group), not systematic prevention of venous thrombosis treatment. Results On the first day after operation, the platelets in the treatment group were significantly decreased compared with that before operation (P <0.01), and returned to the preoperative level on the third day and then continued to rise until the fifth day (P <0.01) , Maintained their peak status on the 10th to 15th day, then decreased gradually and dropped to the preoperative level on the 30th day. None of the patients in the treatment group had venous thrombosis. Control group of patients with venous thrombosis occurred in 3 cases, the incidence was 23%. Conclusion Combined spleen and pancreatic body tail resection for advanced gastric cancer patients within 1 month after surgery to closely monitor changes in platelet count, and in accordance with the rules of platelet timely anticoagulant therapy to prevent postoperative venous thrombosis.