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目的:评价低分子肝素在原发性肝癌切除术后预防静脉血栓形成的疗效及安全性。方法:将105例行原发性肝癌切除治疗的患者随机分为抗凝组48例,术后第2~7天每天皮下注射低分子肝素5 000 U;非抗凝组57例,术后未行皮下注射低分子肝素治疗。统计两组患者术后静脉血栓(venous thromboemolism,VET)形成发生率、腹腔出血发生率、切口渗血及切口周围皮肤瘀斑发生率,监测术后第1天和第6天血红蛋白量变化及术后第6天凝血功能,统计术后腹腔引流液总量,行统计学分析。结果:抗凝组术后未见VTE发生(0/48);非抗凝组术后发生5例VTE,发生率8.87%(5/57);抗凝组VTE术后发生率较非抗凝组显著降低(P=0.043)。抗凝组和非抗凝组术后腹腔活动性出血发生率、血红蛋白变化量、腹腔引流总量、凝血功能、出现切口渗血及切口周围皮肤瘀斑等指标之间无显著性统计学差异(P>0.05)。结论:原发性肝癌切除术后易伴发VTE,低分子肝素预防原发性肝癌切除术后VTE疗效确切且安全。
Objective: To evaluate the efficacy and safety of low molecular weight heparin in preventing venous thrombosis after resection of primary liver cancer. Methods: A total of 105 patients with primary hepatocellular carcinoma (HCC) were randomly divided into anticoagulation group (n = 48) and subcutaneous injection of low molecular weight heparin (n = 5000) 2 to 7 days postoperatively Subcutaneous injection of low molecular weight heparin treatment. The incidence of postoperative venous thromboembolism (VET), the incidence of intraperitoneal hemorrhage, incision bleeding and the incidence of skin ecchymosis around the incision were recorded. The changes of hemoglobin on the first day and the sixth day after operation were observed Six days after the coagulation function, the total amount of abdominal drainage fluid statistics, line statistical analysis. Results: No VTE occurred in the anticoagulation group (0/48). Five cases of VTE occurred in the non-anticoagulation group (8.87%, 5/57). The incidence of VTE in the anticoagulation group was significantly higher than that in the non-anticoagulation group Group was significantly lower (P = 0.043). There was no significant difference between the rates of active peritoneal bleeding, hemoglobin change, total peritoneal drainage, coagulation function, incision bleeding and skin ecchymosis around the incision in the anticoagulation and non-anticoagulation groups P> 0.05). Conclusion: VTE is easy to be associated with resection of primary liver cancer and low molecular weight heparin is effective and safe in preventing VTE after resection of primary liver cancer.