CAJ | 학술논문

目的：探讨低分子肝素对食管癌患者术后血栓性疾病发生的影响。方法将360例行食管癌手术的患者随机分为观察组与对照组，每组180例。观察组于术后第1天皮下注射低分子肝素4000～6150 IU或低分子肝素钠4000～6000 IU，每天1次，连用5 d。对照组给予常规方法进行治疗。术前及术后5天测定患者的血小板（ PLT）、活化部分凝血活酶时间（ APTT）、纤维蛋白原（ Fib）、D-二聚体（ D-D）及凝血酶原时间（ PT）。观察2组食管癌手术后的胸腔积液引流量。结果手术前2组食管癌患者PT明显缩短，D-D及Fib均明显高于正常范围，手术后第1天2组食管癌患者的PT明显缩短，D-D较术前明显升高（P＜0．05）。观察组术后第2天PT达到最低水平，D-D及Fib达到最高水平。术后第5天观察组PT较术前及术后第1天延长，D-D及Fib明显降低。观察组与对照组相比，Fib、PT在术后2～5天及D-二聚体在术后1～5天的差异均有统计学意义（P＜0．05）。食管癌手术后观察组的平均胸腔积液引流量为（527．9±132．5）ml，对照组的平均积液引流量为（531．6±121．4）ml，2组差异无统计学意义（χ2＝0．385，P＞0．05）。结论经预防性的给予低分子肝素进行治疗后，可以明显降低食管癌患者术后血栓性疾病的发生率。
목적：탐토저분자간소대식관암환자술후혈전성질병발생적영향。방법장360례행식관암수술적환자수궤분위관찰조여대조조，매조180례。관찰조우술후제1천피하주사저분자간소4000～6150 IU혹저분자간소납4000～6000 IU，매천1차，련용5 d。대조조급여상규방법진행치료。술전급술후5천측정환자적혈소판（ PLT）、활화부분응혈활매시간（ APTT）、섬유단백원（ Fib）、D-이취체（ D-D）급응혈매원시간（ PT）。관찰2조식관암수술후적흉강적액인류량。결과수술전2조식관암환자PT명현축단，D-D급Fib균명현고우정상범위，수술후제1천2조식관암환자적PT명현축단，D-D교술전명현승고（P＜0．05）。관찰조술후제2천PT체도최저수평，D-D급Fib체도최고수평。술후제5천관찰조PT교술전급술후제1천연장，D-D급Fib명현강저。관찰조여대조조상비，Fib、PT재술후2～5천급D-이취체재술후1～5천적차이균유통계학의의（P＜0．05）。식관암수술후관찰조적평균흉강적액인류량위（527．9±132．5）ml，대조조적평균적액인류량위（531．6±121．4）ml，2조차이무통계학의의（χ2＝0．385，P＞0．05）。결론경예방성적급여저분자간소진행치료후，가이명현강저식관암환자술후혈전성질병적발생솔。
Objective To explore the effect of low molecular weight heparin on thrombotic disease in postoperative e -sophageal carcinoma .Methods 360 cases of esophageal cancer were randomly divided into the observation group and the control group ( n =180 ) .The observation group received subcutaneous low molecular weight heparin or subcutaneous low molecular weight heparin sodium 4 000~6 000 IU daily from the 1st of surgery for 5 days,and the control group received conventional treat-ment.PLT,APTT,Fib,D-D and PT of the 2 groups were detected .Pleural effusion drainage of the 2 groups were compared .Re-sults Before surgery ,PT was shorter than normal range ,but Fib and D-D were higher .First day after surgery ,PT decreased sig-nificantly,while D-D increased than before surgery (P<0.05).On the 2nd day,the PT reached the lowest level ,but the Fib and D-D reached the highest level .On the 5th day,the PT of the observation group extended while Fib and D-D decreased significant-ly.Fib and PT in 2~5 days and D-D in 1~5 days of the 2 groups had statistical significance (P<0.05).The postoperative aver-age pleural effusion drainage of the observation group and the control group were (527.9 ±132.5) ml and (531.6 ±121.4) ml, there had no statistical difference (χ2 =0.385,P>0.05).Conclusion Preventive low molecular weight heparin treatment can significantly reduce the incidence of thrombotic diseases .