The Effects Of Low Molecular Weight Heparin On Coagulation Function In Patients With Gastrointestinal Tumors At Different Times After Operation

Objective:The incidence of perioperative venous thromboembolism in cancer patients is about 5 times higher than that in the general population,so patients need anticoagulation prophylaxis,and postoperative patients are at risk of bleeding,which are contradictory.The purpose of this study was to investigate the effect of the anticoagulant drug low molecular weight heparin at different times during the perioperative period on coagulation function,venous thromboembolism and bleeding in patients with gastrointestinal tumors.Methods:We collect and record the clinical date of the patients who were hospitalized in the Department of Gastrointestinal Surgery,eastern district of Shandong Province Hospital from June 2021 to February 2022,undergoing gastric or colorectal tumor surgery.A total of 82 patients met the inclusion criteria and were randomized into 2 groups.The patients were given low molecular weight heparin by subcutaneous injection within 24 hours after surgery and 24 hours after surgery.0.4m 1:4000AXaIU/time,1 time/day.The clinical date includes general information,perioperative laboratory examination results,preoperative and postoperative ultrasonography of deep and superficial veins of both lower limbs,postoperative drainage volume of abdominal cavity,pulmonary embolism symptoms and Caprini score.The statistical software SPSS 25.0 was used for statistical analysis of the data.The enumeration data were expressed by the number of cases and percentages,and the measurement data were all represented by the mean ± standard deviation table;the measurement data were tested for normality,the independent samples T test was used for those that conformed to the normal distribution,and the non-parametric test was used for those that did not conform to the normal distribution.A P value<0.05 indicated a statistically significant difference.Outcomes:(1)There was no significant difference in the effect of low molecular weight heparin on postoperative bleeding and drainage in patients with gastrointestinal tumors at different time after operation.(2)In patients with gastrointestinal tumors,subcutaneous injection of low molecular weight heparin within 24 hours after surgery showed better C-reactive protein(P=0.010)and fibrin degradation products(P=0.026)on the 3rd day after surgery.(3)From preoperative to the first day after operation,the changes of platelets(P=0.043)in early group were more obvious than those in delay group,and the difference was statistically significant.From the first day after operation to the third day after operation,the changes of C-reactive protein(P=0.008)and blood clot formation rate(P=0.029)in early group were more obvious than those in delay group,and the difference was statistically significant.(4)There was no significant difference between the two groups in terms of venous thromboembolism.Conclusion:Anticoagulation with low-molecular-weight heparin at different times after surgery has similar preventive effects on patients with venous thromboembolism syndrome.Early use of low-molecular-weight heparin does not increase the risk of bleeding in patients,on the contrary,in the early postoperative changes of coagulation function,the number of platelets can be reduced,the rate of clot formation can be prolonged,and the increase of C-reactive protein can be slowed down,and the levels of C-reactive protein and fibrin degradation products are lower than delay group,which plays a certain role in preventing thrombosis.Therefore,considering the safety and efficacy,low molecular weight heparin can be used in advance to prevent the occurrence of venous thromboembolism after surgery.