Efficacy observation of low-molecular-weight heparin calcium in preventing lower limb deep vein thrombosis after rectal cancer surgery / 肿瘤研究与临床

ABSTRACT

Objective:To explore the effect of low-molecular-weight heparin calcium in preventing lower limb deep vein thrombosis after rectal cancer surgery.Methods:A retrospective case-control study was conducted. The clinical data of 30 rectal cancer patients with postoperative subcutaneous injection of low-molecular-weight heparin calcium in Beijing Hepingli Hospital from February 2018 to February 2022 were retrospectively analyzed, and 30 patients wearing antithrombotic elastic socks during the same period were selected as controls. In the antithrombotic elastic socks group, the appropriate thrombotic elastic socks were selected according to the actual situation of the patients after operation. Low-molecular-weight heparin calcium group was given subcutaneous injection of low-molecular-weight heparin calcium on the 2nd day after operation. The indexes of coagulation function, situation of postoperative lower limb deep vein thrombosis and perioperative indexes were analyzed.Results:The age of patients in the low-molecular-weight heparin calcium group was (62±12) years old, with 17 women and 13 men. The age of patients in the antithrombotic elastic socks group was (63±1) years old, with 18 women and 12 men. Before prevention, there were no significant differences in platelet count (Plt), activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), fibrinogen (FIB), D-dimer (D-D) levels between the two groups (all P > 0.05). After prevention, the FIB and D-D levels of patients in the low-molecular-weight heparin calcium group [(3.3±0.7) g/L and (341±30) μg/L] were lower than those in the antithrombotic elastic socks group [(4.9±0.6) g/L and (428±40) μg/L] ( t values were 9.51 and 9.61, both P < 0.05), but there were no significant differences in Plt, APTT, TT and PT between the two groups (all P > 0.05). The rate of lower limb deep vein thrombosis in the low-molecular-weight heparin calcium group was lower than that in the antithrombotic elastic socks group [6.67% (2/30) vs. 26.67% (8/30), χ2 = 4.32, P < 0.05]. The drainage flow of anterior sacral drainage tube in the two groups decreased gradually on the 1st, 2nd, 3rd and 4th day after surgery, but there were no significant differences between the two groups (all P > 0.05). The thrombosis time of patients in the low-molecular-weight heparin calcium group was longer than that in the antithrombotic elastic socks group [(84±9) h vs. (73±10) h, t = 4.81, P < 0.05], but there were no significant differences between the two groups in the intraoperative bleeding amount, operation time and postoperative hospital stay (all P > 0.05). Conclusions:Compared with antithrombotic elastic socks, low-molecular-weight heparin calcium is more effective and safer in the prevention of lower limb deep vein thrombosis after rectal cancer surgery.