The Curative Effect Oanalysis Of Low Molecular Heparin In The Lung Cancer Patients With High Blood Coagulation State During Radiation And Chemotherapy

ObjectiveIt is indicated by clinical researches that most cancer patients have high blood coagulation state,and there is a significantly increased risk of venous thrombosis,but in the status quo the clinical anticoagulant treatment in patients with cancer is not satisfactory,probably because the high blood coagulation does not cause enough attention.The experiment is to be observed on the effect of low molecular heparin on high blood coagulation state patients with lung cancer during concurrent chemoradiation,and to evaluate anticoagulant effect of low molecular heparin on high blood coagulation state of patients by analyzing the blood coagulation indexes,the incidence of thrombotic events,to discuss influence of the low molecular heparin’s on the quality of life and survival time by recording the survival time of lung cancer patients,KPS scores,to provide a more powerful theoretical support for patients with high coagulation state by using low molecular heparin to prevent anticoagulant thrombosis.Method140 hospitalized patients with lung cancer collected from 2014.1 to 2015.3,who have no surgical indications or refusing surgery and have high blood coagulation state,are treated with anticoagulant therapy.All of the patients are confirmed by pathological diagnosis,with exceptional coagulation index through laboratory tests.The 140 patients are divided into radiation group,the radiation control group,the chemotherapy group and chemotherapy control group,35 patients in each group;The two treatment groups are treated with low molecular heparin,however,the control groups are treated with radiation or chemotherapy.Blood clotting index,the incidence of thrombotic events,the incidence of bleeding events,patient surial,KPS scores,etc are analyzed statistically.ResultFour groups of patients are suffering from high blood coagulation state,there was no statistically significance among the groups.After the radiotherapy group are treated with anticoagulant therapy,(1)plasma D-D,FIB,PLT level decline obviously,t value are 13.82,8.38,5.279,P<0.05,the difference was statistically significant,(2)there is no new vein thrombosis;after the radiation group are treated,(1)plasma D-D,PLT level increased significantly,t value were 4.959,6.524,P<0.05,the difference was statistically significant,(2)there occurs 1 pulmonary embolism,2 cases of lower extremity deep vein thrombosis,1 cases of jugular vein thrombosis,and the incidence of venous thrombosis was 11.4%;there are comparisons of the radiation treatment group and the control group(1)plasma D-D,FIB,PLT in radiation group are significantly lower than radiation controls,t value were 13.71,5.762,7.340,P<0.05,the difference is statistically significant,(2)the incidence of thrombotic events in both groups are 0%and 11.4%,chi-square=2.386,P=0.122>0.05,there was no statistically significant difference,(3)1 year survival rates of the two groups were 80%,77.1%,chi-square=0.085,P=0.77>0.05,there was no statistically difference.After chemotherapy group is treated with anticoagulant therapy,(1)plasma D-D,FIB,PLT level declined obviously,t value were 15.11,10.25,6.86,P<0.05,the difference was statistically significant,APTT and PT values obviously prolong,t value were 3.10,2.64,P<0.05,the difference was statistically significant,(2)there is 1 patients with lower limb venous thrombosis confirmed no progress by colour ultrasound,no new found of lower extremity deep vein thrombosis or pulmonary embolism;After chemotherapy in the control group,(1)plasma D-D,FIB,PLT level increased significantly,t value were 8.620,4.262,7.681,P<0.05,the difference was statistically significant,(2)1 patients pulmonary embolism,4 cases of lower extremity deep vein thrombosis,1 case of superficial vein thrombosis,the incidence of venous thrombosis was 17.1%;there are comparisons of chemotherapy treatment group with control group after treatment,(1)plasma D-D,FIB,PLT,PT in the treatment group significantly decreased or extended,t value were 18.90,9.87,9.744,2.02,P<0.05,the difference was statistically significant,(2)the rates of thromboembolism in the two groups are 0%and 17.1%respectively,chi-square=4.557,P=0.033<0.05,the difference was statistically significant,(3)1 year survival rates in the two groups were 77.1%,74.3%,chi-square=0.078,P=0.780>0.05,there is no statistically significant difference.There are some comparisons of the chemotherapy control group with radiotherapy control group after treatment,1)plasma D-D,FIB,PLT level in the chemotherapy are obviously higher than the control group,t value were 2.646,3.247,2.472,P<0.05,the difference was statistically significant,(2)the rates of venous thrombosis in the two groups are 17.1%,11.4%,chi-square=0.117,P=0.733>0.05,there was no statistically significant difference.All the patients of the experimental group do not appear adverse events such as significant bleeding.ConclusionLow molecular heparin can improve high blood coagulation state in the lung cancer patients,and reduce the incidence of VTE,has no obvious bleeding adverse events and has high validity and security.It is suggested that patients with lung cancer and increased risk of developing high blood coagulation state VTE use low molecular heparin anticoagulation to prevent venous thrombosis.Tests have shown that patients with chemotherapy is an independent risk factors for high blood coagulation state,anticoagulant intervention is necessary for these patients.Radiation therapy is also a risk factor for high blood coagulation,but research on this respect are lacking.