目的研究存在血液高凝状态的肺癌患者在放化疗期间应用低分子肝素治疗的效果。方法将2014年1月—2015年3月收治的140例存在高凝状态的肺癌患者分为放疗试验组、放疗对照组、化疗试验组、化疗对照组各35例。放疗试验组及化疗试验组在放化疗治疗期间给予低分子肝素抗凝治疗,放疗对照组及化疗对照组仅给予相应放疗、化疗。记录比较两组静脉血栓(VTE)发生情况、原发病灶缓解情况、一年生存情况、Karnofsky功能状态评分(KPS评分)及抗凝治疗不良反应发生情况。计量资料组间比较采用单因素方差分析,若方差不齐,进行近似F检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果放疗试验组、化疗试验组、放疗对照组与化疗对照组抗凝治疗后,VTE发生率分别为0、0、11.4%、17.1%,四组比较差异有统计学意义(P<0.05)。放疗试验组、化疗试验组、放疗对照组与化疗对照组治疗后KPS评分分别为(92.00±6.77)、(92.00±7.59)、(91.71±6.64)、(91.14±6.76)分,均较治疗前的(87.71±6.90)、(88.00±6.77)、(89.14±6.12)、(88.86±6.31)分明显升高,差异均有统计学意义(均P<0.05)。治疗后,放疗试验组、化疗试验组、放疗对照组与化疗对照组疾病有效率和疾病控制率、1年生存率分别为85.7%、82.9%、74.2%、68.6%、94.3%、94.3%、88.6%、85.7%、80.0%、77.1%、77.1%、74.1%,四组比较差异均无统计学意义(均P>0.05)。试验组所有患者均未出现严重出血等不良事件。结论低分子肝素可以有效降低患者(VTE)发生率,配合放化疗可以明显改善患者的生活质量,安全性较好。 Objective To study the effect of low molecular weight heparin on patients with lung cancer with hypercoagulable blood during radiochemotherapy. Methods One hundred and fourteen patients with hypercoagulable lung cancer who were admitted from January 2014 to March 2015 were divided into radiotherapy group, radiotherapy group, chemotherapy group and chemotherapy group. Radiotherapy experimental group and chemotherapy experimental group were given low molecular weight heparin anticoagulant therapy during radiotherapy and chemotherapy, radiotherapy control group and chemotherapy control group were given only radiotherapy and chemotherapy. The incidence of venous thrombosis (VTE), remission of primary lesion, one-year survival, Karnofsky functional status score (KPS) and incidence of anticoagulation adverse reactions were compared between the two groups. One-way analysis of variance (ANOVA) was used to compare the measurement data. If the variance was not uniform, the approximate F test was used and the count data was analyzed byχ2 test. P <0.05 was considered as statistically significant. Results The incidences of VTE after radiotherapy, chemotherapy, radiotherapy and chemotherapy were 0, 0, 11.4% and 17.1%, respectively. The differences between the four groups were statistically significant (P <0.05). The KPS scores of radiotherapy group, chemotherapy group, radiotherapy control group and chemotherapy control group after treatment were (92.00 ± 6.77), (92.00 ± 7.59), (91.71 ± 6.64) and (91.14 ± 6.76) points respectively, (87.71 ± 6.90), (88.00 ± 6.77), (89.14 ± 6.12) and (88.86 ± 6.31), respectively. The difference was statistically significant (all P <0.05). After treatment, the effective rate of disease and the rate of disease control and 1-year survival in the radiotherapy test group, the chemotherapy test group, the radiotherapy control group and the chemotherapy control group were 85.7%, 82.9%, 74.2%, 68.6%, 94.3%, 94.3% 88.6%, 85.7%, 80.0%, 77.1%, 77.1%, 74.1% respectively. There was no significant difference among the four groups (all P> 0.05). All patients in the experimental group did not have any serious bleeding or other adverse events. Conclusion Low molecular weight heparin can effectively reduce the incidence of patients (VTE), combined with radiotherapy and chemotherapy can significantly improve the quality of life of patients with better safety.