Effect of low molecular weight heparin on venous thromboembolism disease in thoracotomy patients with cancer

Abstract

Background: Much attention has been given to venous thromboembolism (VTE) disease, and many guidelines for prophylaxis have been published. However, there are few published data on patients who underwent thoracotomy. This study is to compare the effect of low molecular weight heparin (LMWH) combined mechanical approaches with mechanical approaches alone in prevention of VTE in the post thoracotomy cancer patients. Methods: This study used a prospective, randomized-controlled design. Patients with cancer who were scheduled for thoracotomy were divided into two groups: group A and group B. In group A, patients were given intermittent pneumatic compression (IPC) and elastic stockings (ES) postoperatively. Additionally, at 24 hours post-operation, patients were subcutaneously injected with LMWH calcium (nadroparin calcium; GlaxoSmithKline, China) for 7 days. In group B, patients were only given postoperative IPC and ES. The primary end points were incidence of pulmonary embolism (PE), deep vein thrombosis (DVT), and the PE severity index (PESI) of PE patients. The secondary end points were hemoglobin (HGB), platelet (PLT), D-dimer, the PO2/FiO2 ratio (P/F) at postoperative day (POD) 7, the chest drainage time (CDT) and the length of stay (LOS) in hospital after operation. Results: A total of 90 patients were included in the final data analysis (40 patients in group A and 50 patients in group B). At POD7, the incidence of PE, DVT and PESI was 17.50%, 5.00% and 102.14±9.87, respectively, in group A. And 8.00%, 8.00% and 97.00±4.24, respectively, in group B. There were no significant differences between two groups (all P values were >0.05). There were no significant differences of HGB, PLT, D-dimer and P/F between two groups at the 7th day post operation (all P value >0.05).Conclusions: LMWH combined mechanical prophylaxis did not significant reduced the rate of VTE in thoracotomy cancer patients.

Discussion on Curative Effect and Safety of Small-dosage Alteplase Combined with Urokinase in Treatment of Acute Pulmonary Embolism

“…The drug can work rapidly. Except rapid thrombus dissolution, it can also promote improvement and recovery of lung tissue reperfusion and obviously improve right cardiac insufficiency [9] . Multiple research results show that, large-dosage alteplase can increase patients' hemorrhage rate [10] .…”

Application of soliton solution theory to pulse wave modeling

“…1 pulsefor soliton. So, the N-soliton solutions of the Kortewegde Vries equation are used as the analytical form of soliton waves 24,25,26 .…”

Deep vein thrombosis and pulmonary embolism following lung resection

“…Dong et al (1), compared LMWH combined with mechanical prophylaxis, with intermittent pneumatic compression and elastic stockings, against mechanical prophylaxis only for inpatients who underwent thoracotomy for lung or oesophageal cancer-with moderate risk of VTE-and they did not find that the first group had better results in VTE incidence or length of hospital stay. There were no bleeding events in the LMWH group.…”

“…Venous thromboembolism (VTE), which contains deep vein thrombosis (DVT) and pulmonary embolism (PE), is one of the most common complications in cancer as well as a major surgery-related complication (1). Malignancy has been associated with a 6 to 7-fold increased risk of DVT and a 3-fold increased risk of PE.…”