卵巢上皮性癌患者术后预防静脉血栓的临床意义

发布时间：2018-05-10 14:14

本文选题：低分子肝素 + 医用弹力袜　；参考：《现代妇产科进展》2015年01期

【摘要】：目的:探讨卵巢上皮性癌患者术后低分子肝素联合医用弹力袜预防静脉血栓的临床效果。方法:将135例疑似卵巢恶性肿瘤患者随机分为对照组和血栓预防组,经术后病理确诊卵巢上皮性癌者78例,其中对照组(38例)、血栓预防组(40例)。比较两组患者的手术时间、是否满意减瘤、出血量、输血量及卧床天数。治疗组于术前24h前穿戴医用弹力袜,术后24h开始注射低分子肝素,直至出院;对照组不采用预防性措施。术前和术后D1、D3、D5、D7检测血常规、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)及纤维蛋白原(FIB)等指标。结果:两组的手术时间、是否满意减瘤、出血量、输血量及术后卧床天数比较,差异均无统计学意义(P0.05),两组术前术后组间及组内血PLT、PT、APTT比较,差异均无统计学意义(P0.05)。与对照组比较,血栓预防组术后FIB、D-D值减低,血栓发生率明显减少,差异均有统计学意义(P0.05)。结论:低分子肝素联合医用弹力袜可有效预防卵巢癌患者术中及术后静脉血栓发生,且不增加术后出血等风险,是安全有效的。
[Abstract]:Objective: to investigate the clinical effect of low molecular weight heparin (LMWH) combined with medical elastic socks in the prevention of venous thrombosis in patients with epithelial ovarian carcinoma. Methods: 135 patients with suspected ovarian malignant tumor were randomly divided into control group and thromboprophylaxis group. 78 cases of ovarian epithelial carcinoma were confirmed by pathology after operation, 38 cases of control group and 40 cases of thrombus prevention group. The operative time, tumor reduction, blood loss, blood transfusion and bed rest days were compared between the two groups. In the treatment group, medical elastic socks were worn 24 hours before operation, and low molecular weight heparin was injected 24 hours after operation until discharge, while the control group did not take preventive measures. Blood routine, prothrombin time, activated partial thromboplastin time (APTTT), D-dimer (D-D) and fibrinogen (FIBs) were detected before and after operation. Results: there was no significant difference in the time of operation, satisfactory tumor reduction, blood loss, blood transfusion and postoperative bed rest days between the two groups (P 0.05), but there was no significant difference between the two groups before and after operation (P 0.05). Compared with the control group, the D-D value of FIBG and the incidence of thrombus were significantly decreased in the thromboprophylaxis group, and the difference was statistically significant (P 0.05). Conclusion: low molecular weight heparin combined with elastic socks is safe and effective in preventing intraoperative and postoperative venous thrombosis in patients with ovarian cancer without increasing the risk of postoperative bleeding.
【作者单位】：安徽省肿瘤医院妇瘤外科;
【基金】：2008年安徽省科技攻关计划项目(No:08010302101)
【分类号】：R737.31

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