Efficacy of low molecular weight heparin combined with intervention of integrated medical-nursing enhanced recovery after surgery in preventing deep vein thrombosis after colorectal cancer surgery
10.12173/j.issn.1008-049X.202405117
- VernacularTitle:低分子肝素联合医护一体化快速康复外科干预对结直肠癌术后下肢DVT的预防效果
- Author:
Lili WU
1
;
Yantao ZHANG
Author Information
1. 杭州市中医院普外科(杭州 310007)
- Keywords:
Low molecular weight heparin;
Integrated medical-nursing;
Enhanced recovery after surgery;
Deep vein thrombosis;
Colorectal cancer;
Thrombosis prevention
- From:
China Pharmacist
2024;27(8):1343-1352
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the preventive effect of low molecular weight heparin(LMWH)combined with integrated medical-nursing enhanced recovery after surgery(ERAS)intervention on postoperative deep vein thrombosis(DVT)in colorectal cancer(CRC)patients.Methods A retrospective collection of postoperative CRC patients at Hangzhou Hospital of Traditional Chinese Medicine from January 2021 to October 2023 was conducted.Patients were divided in the combined intervention group(LMWH combined with ERAS)and the control group(LMWH)based on the intervention methods.The primary observation indicators of this study was the incidence of lower extremity DVT.Secondary observation indicators included changes in coagulation parameters[D-dimer(D-D),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(Fib)]before and after intervention;blood flow velocity in the bilateral popliteal,external iliac,and femoral veins;time to first postoperative anal gas passage,time to resume eating,time to get out of bed and length of hospital stay;postoperative complication rate and adverse drug reaction rate.Results A total of 110 patients were included in the study,with 55 in the combined intervention group and 55 in the control group.There were no statistically significant differences between the two groups in terms of baseline characteristics,coagulation-related indicators before intervention,and lower limb venous blood flow velocity(P＞0.05).After 7 and 14 days of intervention,TT,PT,APTT,and Fib levels in both groups were higher compared to before the intervention,while D-D levels decreased(P＜0.05).There were no significant differences in TT,PT,and APTT between the two groups(P＞0.05),but the D-D level in the combined intervention group was lower than that in the control group(P＜0.05),and the Fib level was higher than that in the control group(P＜0.05).After 14 days of intervention,the blood flow velocities in the bilateral popliteal,external iliac,and femoral veins were higher in the combined intervention group than in the control group(P＜0.05),and the incidence of DVT was lower(1.82％vs.7.27％),but the difference was not statistically significant(P=0.363).The combined intervention group had shorter postoperative time to first anal gas passage,resumption of eating,getting out of bed,and length of hospital stay compared to the control group(P＜0.05).Finally,there were no statistically significant differences between the two groups in the incidence of postoperative complications and adverse reactions to LMWH(P＞0.05).Conclusion The combined intervention of LMWH and ERAS can effectively improve the hypercoagulable state in postoperative CRC patients,increase the venous blood flow velocity in the lower limbs,reduce the incidence of DVT,promote postoperative recovery,and has good safety.
