超声监测胸外科肿瘤术后低分子肝素预防深静脉血栓效果的观察

对30例胸外科恶性肿瘤手术患者于术后24h开始每12小时腹壁皮下注射低分子肝素0．3ml，连续3d，行超声检查观察深静脉血栓形成（DVT）情况（研究组），并以30例未应用肝素者为对照。术后检出DVT7例，其中研究组1例（3％），发生率显著低于对照组的20％（6例）（P〈0．05），血栓最早于术后1d检出，单纯小腿肌间静脉血栓6例，胫后静脉血栓1例。与对照组比较，研究组术后1d时纤维蛋白原（FIB）、D-二聚体无显著变化（P〉0．05），术后3d时FIB、D-二聚体显著降低（P〈0．05）。低分子肝素显著降低术后高凝状态，减少下肢DVT发生；超声可作为术后早期监测无痒状小腿DVT及预防措旆效果的首诜方法。

Color Doppler ultrasonography in monitoring thrombosis of lower limb deep vein after malignantthoracic tumor surgery

Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group （group A） and treatment group （group B）. 0. 3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery. Bilateral venous sonography of lower extremities were performed before and dl, d3 after operation. Blood coagulation marks PLT, PT, APTT, Fibrinogen （FIB） and D-dimer were determined at the same time. Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients： 1 in group B（3%） and 6 in group A（20%） （P〈0.05）. Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient. FIB and D-dimer had no significant difference on the dl （ P 〉 0. 05 ） between two groups, butsignificantly lower on the d3 after surge group B than that ill group A （ P 〈 O. 05 ）. eight heparin reduced blood hypereoagulation state and thromlosis. Color Doppler sonography can be a va]uable method deteeting asymplomatit deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.