单位:[1]Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,People’s Republic of China.华中科技大学同济医学院附属同济医院妇产科教研室妇产科学系[2]Division of Vascular Surgery,Hepatic Surgery Center,Department of Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,People’s Republic of China华中科技大学同济医学院附属同济医院肝脏外科外科学系外科学系外科学系心脏大血管外科
Background: In this study, we investigate the incidence of venous thrombosis (VT), and evaluate the effectiveness and safety of 3 major thromboprophylaxes and the potential risk factors for VT in women undergoing surgery for a gynecological malignancy. Methods: We performed a randomized controlled trial of 307 patients undergoing laparoscopic surgery for gynecological malignancies at a single institution from January 2016 to October 2017. Patients were divided into 3 groups: one receiving a half dose of low-molecular-weight heparin sodium injection (FLUXUM, Alfa Wassermann, Italy) delivered by injection, one receiving a full dose of FLUXUM, and a third group receiving an Argatroban injection. Results: None of the patients in our study developed a pulmonary embolism, bleeding, or infectious complications. There were no statistical differences in the rate of deep venous thrombosis (DVT) (0%, 0%, and 2.38%) and the superficial venous thromboembolism (SVT) (15.66%, 8.97%, and 18.6%) among the 3 groups. None of the patients developed symptomatic VT. The effect of treatment on alanine aminotransferase and aspartate aminotransferase differed between the groups, with a minimal effect in the Argatroban group, and all 3 methods resulted in minimal impairment of renal function. Decreased hemoglobin, elevated levels of D-dimer, and prothrombin time were closely related to thrombogenesis. Conclusion: In conclusion, the incidence of postoperative thrombosis in gynecological malignancy among these Chinese people is not as low as we had originally presumed. Argatroban is not more effective than Parnaparin as a direct thrombin inhibitor, but it has less influence on liver function, which is beneficial for patients undergoing chemotherapy. Hemoglobin, D-dimer, and prothrombin time may be used to predict or detect thrombogenesis.
基金:
National Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [81772775, 81372806, 81502252, 81572569]
第一作者单位:[1]Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,People’s Republic of China.
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推荐引用方式(GB/T 7714):
yu ruidi,nansubuga faridah,yang jun,et al.Efficiency and safety evaluation of prophylaxes for venous thrombosis after gynecological surgery[J].MEDICINE.2020,99(25):doi:10.1097/MD.0000000000020928.
APA:
yu,ruidi,nansubuga,faridah,yang,jun,ding,wencheng,li,kezhen...&wei,juncheng.(2020).Efficiency and safety evaluation of prophylaxes for venous thrombosis after gynecological surgery.MEDICINE,99,(25)
MLA:
yu,ruidi,et al."Efficiency and safety evaluation of prophylaxes for venous thrombosis after gynecological surgery".MEDICINE 99..25(2020)