徐金华　周锐　徐光如　张明辉

[摘要] 目的 分析低分子肝素预防晚期肿瘤长期卧床患者深静脉血栓形成疗效。 方法 该研究随机选取2013年5月—2015年5月该院诊治的80例晚期肿瘤长期卧床患者为对象，所有患者化验栓溶二聚体及纤维蛋白原降解产物升高。随机分组。其中，常规组不用低分子肝素，而低分子肝素组患者给予10 000 U低分子肝素皮下注射，2次/d，一共治疗两周。对比分析两组患者下肢深静脉血栓发生率差异，并对比两组不良反应。 结果 采用χ2检验分析进行数据统计，常规组患者下肢深静脉血栓发生率明显高于低分子肝素组，差异有统计学意义（P<0.05）。两组患者均未发生严重不良后果，常规组患者没有出血症状，低分子肝素组患者仅有1例出现皮下轻微出血，差异无统计学意义（P>0.05）。两组均无患者出现肺栓塞。 结论 低分子肝素预防晚期肿瘤长期卧床患者深静脉血栓形成疗效非常显著，其有利于显著降低下肢深静脉血栓发生率，且安全性高，不良反应轻微，值得推广。

[关键词] 低分子肝素；晚期肿瘤长期卧床患者；深静脉血栓；疗效评价

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）09（c）-0068-02

[Abstract] Objective To analyze the efficacy of low molecular weight heparin on prevention of deep venous thrombosis of bedridden patients with advanced tumor. Methods 80 bedridden patients with advanced tumor between May 2013 and May 2015 were enrolled in this study. D-dimer and fibrinogen degradation product of the patients were tested and increased. The patients were randomized into the routine group that was not given low molecular weight heparin and the low molecular weight heparin group that was given 100，000U low molecular weight heparin by subcutaneous injection， twice a day for two weeks. The difference in incidence of deep venous thrombosis of the two groups was analyzed and the adverse reactions of the two groups were compared. Results Data statistics were analyzed using Chi-squared test. The incidence of lower extremity deep venous thrombosis of the routine group was significantly higher than that of low molecular weight heparin group and the difference had statistical significance （P<0.05）. No serious adverse event was noted in the two groups. No hemorrhage was found in the routine group and only 1 patient in the low molecular weight heparin group developed mild subcutaneous hemorrhage. The difference had no statistical significance （P>0.05）. No pulmonary embolism was noted in the two groups. Conclusion The efficacy of low molecular weight heparin on prevention of deep venous thrombosis of bedridden patients with advanced tumor is remarkable. It is beneficial to reducing the incidence of lower extremity deep venous thrombosis with high safety and mild adverse reaction， which is worth popularizing.

[Key words] Low molecular weight heparin； Bedridden patients with advanced tumor； Deep venous thrombosis； Efficacy evaluation

晚期肿瘤长期卧床患者由于长期卧床，缺乏运动，且病情严重，血液处于高凝状态，下肢深静脉血栓是常见并发症。下肢深静脉血栓是指下肢深静脉内有血液不正常凝结，致管腔阻塞、静脉回流受阻性疾病[1]。患者临床症状主要表现为：患肢肿胀、疼痛等，若临床不能给予有效控制，则会导致静脉瓣膜损伤，严重时会诱发肺栓塞，从而危及患者生命[2]。基于此，需要采取有效方法进行预防，为观察低分子肝素预防晚期肿瘤长期卧床患者深静脉血栓形成疗效，该研究选取相关病例进行探讨，现报道如下。……