超声监测胸外科肿瘤术后低分子肝素预防深静脉血栓的临床研究

目的探讨应用超声监测胸外科肿瘤术后给予低分子肝素预防深静脉血栓的临床效果。方法将2010年1月至2010年12月间80例行胸外科恶性肿瘤手术治疗的患者随机分为两组，每组各40例。观察组患者术后给予低分子肝素治疗，对照组患者术后未给予低分子肝素治疗，对两组患者进行超声检查，观察深静脉血栓发生的情况。结果两组患者手术时间、胸腔引流量、拔管时间比较差异无统计学意义（P〉0．05）；观察组患者静脉血栓形成率显著低于对照组，差异有统计学意义（P〈0．05）；两组患者D-二聚体、血小板计数（PLIT）和纤维蛋白原（FIB）治疗后均有不同程度的改善，差异有统计学意义（P〈0．05）。治疗1d后两组患者的观察指标比较无显著性差异（P〉0．05），但治疗3天后，FIB和D-二聚体比较，差异有统计学意义（P〈0．05）。结论临床上胸外科肿瘤手术后给予低分子肝素能够有效预防深静脉血栓的形成，超声能够作为早期监测患者下肢深静脉血栓形成的重要方法。

Clinical effect of low molecular weight heparin preventing deep venous thrombosis under ultrasonic monitoring after thoracic tumor surgery

Objective To explore clinical effect of low molecular weight heparin preventing deep venous thrombosis under ultrasonic monitoring after thoracic tumor surgery. Methods 80 patients admitted to our hospital from 2010 January to 2010 December receiving thoracic malignant tumor surgery were randomly divided into two groups. The observation group （40 cases） were given low molecular weight heparin treatment,while the control group （40 case） was not. Ultrasonography was performed on two groups. Deep vein thrombosis was observed. Results Operation time, amount of thoracic cavity drainage, estuation time were not significantly different for both groups （ P 〉 0. 05 ）. The venous thrombosis rate of observation group was significantly lower than that of control group （ P 〈 0. 05 ）. Compared with pre-treatment, D-dimer PLT count and FIB improved in some degree,The differences was significant （P 〈 0. 05 ）. There was no significant difference for all index at 1 day after treatment （P 〉 0.05 ）, but There was significant difference for D- dimer and FIB at 3 day after treatment between the two groups （P 〈 0. 05）. Conclusions Low molecular weight heparin could effectively prevent deep venous thrombosis, and Ultrasonography can be used as an important method of early detection of deep venous thrombosis formatting at lower limbs.