【摘要】 目的 探讨腹腔镜辅助胃癌根治术后低分子肝素钙在预防下肢深静脉血栓形成的价值。方法 选择2020年3月1日至2021年5月1日福建省立医院收治的91例行腹腔镜辅助胃癌根治术者进行前瞻性研究，按随机数表法将患者分成研究组(46例)和对照组(45例)，研究组术后预防性使用低分子肝素钙进行抗凝治疗，对照组未给予抗凝治疗，其他基础治疗措施均一致，比较两组术后第7天D-二聚体水平、活化部分凝血活酶时间、凝血酶原时间、血小板水平、纤维蛋白原水平以及双下肢深静脉血栓形成例数。结果 术后第7天研究组的D-二聚体水平[(4.58±2.17)mg/L]低于对照组[(5.96±3.05)mg/L]，差异有统计学意义(t=2.691，P=0.009)；两组术后活化部分凝血活酶时间、凝血酶原时间、血小板水平、纤维蛋白原水平差异均无统计学意义(P>0.05)。研究组双下肢深静脉血栓形成率[2.2%(1/46)]少于对照组[17.8%(8/45)]，差异有统计学意义(χ~2=6.215，P=0.013)。结论 腹腔镜辅助胃癌根治术后预防性应用低分子肝素钙可减少下肢深静脉血栓形成。更多还原

【Abstract】 Objective To explore the value of low-molecular-weight heparin calcium in the prevention of lower-limb deep vein thrombosis after laparoscopy-assisted radical gastrectomy.Method A total of 91 patients who underwent laparoscopy-assisted radical gastrectomy from March 1,2020 to May 1,2021 were prospectively divided into two groups by random number method.Prophylaxis for deep vein thrombosis with low-molecular-weight heparin (LMWH) initiated postoperatively in the experimental group (n=46),and no postoperative LMWH prophylaxis was administered in the control group (n=45).D-dimer,activated partial thromboplastin time,prothrombin time,platelet,fibrinogen and the occurrence of deep vein thrombosis in the lower limbs on the seventh day after operation were compared between the two groups.Result D-dimer on seventh day after operation was significantly lower in the study group than that in the control group[(4.58±2.17) mg/L vs (5.96±3.05) mg/L,t=2.691,P=0.009].No statistically significant differences were observed in postoperative activated partial thromboplastin time,prothrombin time,platelet and fibrinogen between the two groups (P>0.05).The incidence of lower-limb deep venous thrombosis was significantly lower in the study group than that in the control group[2.2% (1/46) vs 17.8% (8/45),χ~2=6.215,P=0.013].Conclusion Prophylactic application of LMWH calcium can significantly reduce the occurrence of deep vein thrombosis in the lower limbs after laparoscopy-assisted radical gastrectomy.更多还原