不同干预时间下抗凝药物对肺癌手术患者的影响-国际临床研究杂志-CSCIED科技核心评价数据库-手机版

不同干预时间下抗凝药物对肺癌手术患者的影响

Effects of different intervention time of anticoagulant on surgical patients with lung cancer

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DOI	10.12208/j.ijcr.20260118
刊名	国际临床研究杂志 International Journal of Clinical Research
年，卷(期)	2026, 10(3)
作者	崔晓海², 党国信¹, 孙彤宇¹,
作者单位	兵器工业卫生研究所肝胆与血管外科陕西西安; 西安交通大学第一附属医院胸外科陕西西安;
摘要	目的探讨不同时间预防性应用低分子肝素抗凝对肺癌手术患者的影响。方法收集2024年8月-2025年8月在西安交通大学第一附属医院进行手术治疗的180位肺癌患者，根据其抗凝药物使用情况分为术前抗凝组43例、术后抗凝组79例、未抗凝组58例。对比三组手术时间、术中出血量、术后引流管留置时间、术后总引流量、术后住院时间等术中及术后临床指标、术后血栓性疾病的发生情况，并分别于术前及术后第1、2、3、4、5天应用血栓弹力仪对患者进行血栓弹力图检查。结果三组患者手术时间、术中出血量、术后引流管留置时间、术后总引流量、术后住院时间等术中及术后临床指标无统计学差异（P＞0.05）；术后第1、2、3、4、5天，术前抗凝组、术后抗凝组与未抗凝组R值具有统计学差异（P＜0.05），其余各指标均无统计学差异（P＞0.05），术前抗凝组与术后抗凝组各指标差异无统计学意义（P＞0.05）；术前抗凝组、术后抗凝组术后血栓性疾病发生率明显低于未抗凝组（P＜0.05），术前抗凝组与术后抗凝组术后血栓性疾病发生率差异无统计学意义（P＞0.05），三组术后出血发生率差异无显著性（P＞0.05）。结论应用低分子肝素预防性抗凝治疗可降低肺癌手术患者术后静脉血栓形成的风险，术前或术后用药临床效果相当。
Abstract	Objective To explore the effects of prophylactic anticoagulation with low molecular weight heparin (LMWH) and starting administration at different times on patients with lung cancer surgery. Methods 180 lung cancer patients who underwent surgical treatment in our hospital from August 2024 to August 2025 were selected and divided into the preoperative anticoagulant group (n=43), the postoperative anticoagulant group (n=79) and the non-anticoagulant group (n=58) according the use of anticoagulant drugs. The intraoperative and postoperative clinical indicators including operative time, intraoperative bleeding, postoperative drainage tube indwelling time, postoperative chest volume and postoperative hospital stay and the incidence of thrombotic disease after surgery were compared among the three groups. Thromboelastogram was examined before surgery and on the 1st, 2nd, 3rd, 4th and 5th day after surgery. Results There was no significant difference in operative time, intraoperative bleeding, postoperative drainage tube indwelling time, postoperative chest volume and postoperative hospital stay among the three groups (P＞0.05). On the 1st, 2nd, 3rd, 4th and 5th day after operation, there was significant difference in R value among preoperative anticoagulation group, postoperative anticoagulation group and non-anticoagulation group. There was no significant difference between the other indicators(P＞0.05). The incidence of postoperative thrombotic diseases in the preoperative and postoperative anticoagulant group was lower than that in the non-anticoagulant group (P＜0.05). There was no significant difference in the incidence of postoperative thrombotic diseases between preoperative anticoagulant group and postoperative anticoagulant group(P＞0.05). There was no significant difference of the incidence of postoperative bleeding among the three groups (P＞0.05). Conclusion The use of low-molecular-weight heparin prophylactic anticoagulation therapy can reduce the risk of postoperative venous thrombosis in patients with lung cancer. The clinical value of preoperative or postoperative prophylactic anticoagulation is equivalent.
关键词	肺癌；低分子肝素；抗凝治疗；静脉血栓栓塞
KeyWord	Lung cancer; Low molecular weight heparin; Anticoagulation; Venous thromboembolism
基金项目
页码	13-16

参考文献
相关文献

[1] Lutsey PL, Zakai NA. Epidemiology and prevention of venous thromboembolism
[J]. Nat Rev Cardiol. 2023,20(4): 248-262.

[2] KDouketis JD, Spyropoulos AC. Perioperative Management of Patients Taking Direct Oral Anticoagulants: A Review
[J]. JAMA. 2024,332(10):825-834.

[3] Stevens SM, Woller SC, Kreuziger LB, et al. Antithrombotic Therapy for VTE Disease: Second Update of the CHEST Guideline and Expert Panel Report
[J].Chest. 2021,160(6):e545-e608. .

[4] Morán LO, Mateo FJP, Balanyà RP, et al. SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023)
[J]. Clin Transl Oncol. 2024 ,26(11):2877-2901.

[5] Afshari A,Fenger-Eriksen C,Monreal M,et al. European guidelines on perioperative venous thromboembolism prophylaxis: Mechanical prophylaxis
[J].Eur J Anaesth, 2018, 35(2):112-115.

[6] 李辉.《中国胸部恶性肿瘤围手术期静脉血栓栓塞症预防与管理指南（2022版）》解读
[J].中国胸心血管外科临床杂志,2022,29(10):1239-1242.

[7] Wadhwa H, Rohde MS, Xiao M, et al. Preoperative and Postoperative Therapeutic Anticoagulation in Orthopaedic Surgery Increases the Risk of Bleeding: A Systematic Review and Meta-Analysis
[J]. J Am Acad Orthop Surg. 2024 ,32(24):e1270-e1279.

[8] 王怡,田应选,孙莉.老年肺癌患者合并静脉血栓栓塞症的研究进展
[J].中华老年医学杂志,2020,39(1):92-95.

[9] Wang P, Chi L, Zhang Z, et al. Heparin: An old drug for new clinical applications
[J]. Carbohydr Polym. 2022 ,295: 119818.

[10] Heestermans M, Poenou G, Hamzeh-Cognasse H, et al. Anticoagulants: A Short History, Their Mechanism of Action, Pharmacology, and Indications
[J]. Cells. 2022 , 11(20):3214.

[11] Ning D, Zhou L, Fu MY, et al. Safety and efficacy of thrombolytic therapy in the treatment of early pulmonary embolism after thoracic surgery
[J]. J Thorac Dis. 2024 , 16(10):6417-6426.

[12] 杨建业,秦磊磊,李飞龙, 等.血栓弹力图临床应用的研究进展
[J].重庆医学,2020,49(1):149-154.

[13] 马涛,郭少春,李立宏.急性期血栓弹力图与常规凝血功能检测在预测颅脑创伤患者预后中的作用
[J].中华神经外科杂志,2020,36(3):278-280.

引用本文

崔晓海, 党国信, 孙彤宇. 不同干预时间下抗凝药物对肺癌手术患者的影响 [J]. 国际临床研究杂志. 2026; 10; (3). 13 - 16.

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