低分子肝素对行PICC置管的非小细胞肺癌患者疗效观察(1)
[摘要] 目的 探討低分子肝素运用于非小细胞肺癌患者通过PICC途径进行化疗的疗效。 方法 选取我院胸外科2016年7月～2017年6月收治的通过PICC置管途径进行化疗的非小细胞肺癌(NSCLC)患者62例，将纳入的患者按照随机数字表进行随机分为干预组(n=31)与对照组(n=31)。两组患者均采用含铂类联合化疗方案，干预组在此基础上加用低分子肝素钙注射液，2周后进行疗效对比，比较两组患者治疗前与周期化疗结束时疗效、凝血指标变化并观察2周期化疗结束后毒副作用。 结果 研究过程中对照组中有2例患者发生PICC置管术后深静脉血栓(deep vein thrombosis，DVT)，退出本次研究；干预组总有效率(90.32%)，对照组总有效率(62.07%)，两组总有效率具有统计学差异(P<0.05)；两组患者治疗前各项凝血指标组间无差异，P均>0.05，具有可比性；治疗后，干预组的各项凝血指标较治疗前均无统计学差异(P>0.05)；对照组的血小板计数(PLT)、血浆纤维蛋白原(Fib)、D-二聚体(D-D)三个指标的平均值均较前升高，有统计学差异(P<0.05)；两组患者化疗期间，干预组产生的不良反应明显低于对照组(P<0.05)。 结论 低分子肝素运用于非小细胞肿瘤患者通过PICC途径进行化疗的疗效显著，明显缓解机体高凝状态，减少患者化疗期间产生的不良反应的发生率，也有可能降低静脉血栓(deep vein thrombosis，DVT)发生率。
[关键词] 低分子肝素；非小细胞肺癌；PICC；化疗
[中图分类号] R364.1 [文献标识码] B [文章编号] 1673-9701(2018)27-0088-05
[Abstract] Objective To investigate the efficacy of low molecular weight heparin in chemotherapy for patients with non-small cell lung cancer treated with PICC. Methods 62 patients with non-small cell lung cancer (NSCLC) who were treated with chemotherapy through the PICC catheter from July 2016 to June 2017 in thoracic surgery department of our hospital were randomized into intervention group(n=31) and control group(n=31) according to a random number table. Both groups were treated with platinum-containing combined chemotherapy. The intervention group was treated with low-molecular-weight heparin calcium injection based on the above treatment. The curative effect was compared after 2 weeks. The curative effect and blood coagulation index change were compared between the two groups before treatment and at the end of cycle chemotherapy. And the toxic side effects after the end of 2 cycles of chemotherapy were observed. Results During the study， 2 patients in the control group had deep vein thrombosis(DVT) after PICC catheterization and withdrew from the study. The total effective rate was 90.32% in the intervention group and 62.07% in the control group， and there was significant statistical difference in the total effective rate between the two groups(P<0.05). There was no difference between the two groups in the blood coagulation index before treatment， P>0.05. There were no statistically significant difference in blood coagulation parameters before and after treatment， P>0.05. The mean values of platelet count (PLT)， plasma fibrinogen (Fib)， and D-dimer(DD) in the control group were all increased compared with those before(P<0.05)， and there was a statistically significant difference. During the course of chemotherapy，the adverse reactions of the intervention group were significantly lower than those in the control group(P<0.05). Conclusion The use of low molecular weight heparin in the treatment of non-small cell neoplasms by PICC pathway has significant curative effect， which significantly relieves the hypercoagulable state of the body， reduces the incidence of adverse reactions during chemotherapy， and may also reduce the incidence of deep vein thrombosis (DVT)., 百拇医药(傅晓君 徐军 姚源山)
[关键词] 低分子肝素；非小细胞肺癌；PICC；化疗
[中图分类号] R364.1 [文献标识码] B [文章编号] 1673-9701(2018)27-0088-05
[Abstract] Objective To investigate the efficacy of low molecular weight heparin in chemotherapy for patients with non-small cell lung cancer treated with PICC. Methods 62 patients with non-small cell lung cancer (NSCLC) who were treated with chemotherapy through the PICC catheter from July 2016 to June 2017 in thoracic surgery department of our hospital were randomized into intervention group(n=31) and control group(n=31) according to a random number table. Both groups were treated with platinum-containing combined chemotherapy. The intervention group was treated with low-molecular-weight heparin calcium injection based on the above treatment. The curative effect was compared after 2 weeks. The curative effect and blood coagulation index change were compared between the two groups before treatment and at the end of cycle chemotherapy. And the toxic side effects after the end of 2 cycles of chemotherapy were observed. Results During the study， 2 patients in the control group had deep vein thrombosis(DVT) after PICC catheterization and withdrew from the study. The total effective rate was 90.32% in the intervention group and 62.07% in the control group， and there was significant statistical difference in the total effective rate between the two groups(P<0.05). There was no difference between the two groups in the blood coagulation index before treatment， P>0.05. There were no statistically significant difference in blood coagulation parameters before and after treatment， P>0.05. The mean values of platelet count (PLT)， plasma fibrinogen (Fib)， and D-dimer(DD) in the control group were all increased compared with those before(P<0.05)， and there was a statistically significant difference. During the course of chemotherapy，the adverse reactions of the intervention group were significantly lower than those in the control group(P<0.05). Conclusion The use of low molecular weight heparin in the treatment of non-small cell neoplasms by PICC pathway has significant curative effect， which significantly relieves the hypercoagulable state of the body， reduces the incidence of adverse reactions during chemotherapy， and may also reduce the incidence of deep vein thrombosis (DVT)., 百拇医药(傅晓君 徐军 姚源山)