Efficacy Analysis Of Low Molecular Weight Heparin For Preventing Venous Thromboembolism After Gastrointestinal Surgery

Objective:To study the efficacy and security of low molecular weight heparin (LMWH) for preventing venous thromboembolism after gastrointestinal surgery.Methods:255 cases who have undergone gastrointestinal surgeries from September, 2008 to June,2010 were respectively analyzed. All cases conform to the same criterion, which were divided into two groups according to the use of LMWH:the postoperative non-anticoagulant therapy group and the postoperative anticoagulant therapy group. The postoperative non-anticoagulant therapy group includes 123 cases who were received routine treatments postoperatively without the anticoagulant therapy of LMWH. The postoperative anticoagulant therapy group includes 132 cases who were subcutaneously injected LMWH 5000IU per day from 1st day to 7th day after operation in addition to routine treatments. The incidence of the postoperative venous thromboembolism of the two groups were counted. The coagulation index (prothrombin time-. activated partial thromboplastin time,fibrinogen),platelet and D-Dimer in the 7th day after operations were monitored and the total abdominal drainage of the two groups were calculated postoperatively. At last a statistic comparison was made between the two groups.Results:In the postoperative non-anticoagulant therapy group, there were 6 patients suffering from postoperative venous thromboembolism, which include 4 patients suffering from deep venous thromboembolism and 2 patients suffering from pulmonary embolism. However in the postoperative anticoagulant therapy group, there was no patient suffering from postoperative venous thromboembolism。As a result, the incidence of the venous thromboembolism decreased from 4.88% to 0 (P=0.012).Therefore LMWH can significantly reduce the incidence of the postoperative venous thromboembolism. Furthermore there are no significantly statistic differences in the aspects of prothrombin time,activated partial thromboplastin time,platelet,D-Dimer and abdominal drainage between the two groups (P>0.05), but the quantity of fibrinogen in the postoperative anticoagulant therapy group is less than that in the postoperative non-anticoagulant therapy group (P<0.05)Conclusions:LMWH can significantly reduce the incidence of the postoperative venous thromboembolism after gastrointestinal surgery. Compared with the postoperative non-anticoagulant therapy group, the quantity of the fibrinogen of the postoperative anticoagulant therapy group significantly decreased, However prothrombin time,activated partial thromboplastin time,platelet and D-Dimer of the postoperative anticoagulant therapy group do not change significantly. There is no significant difference in the total abdominal drainage between the two groups. Therefore it is a safe and effective anticoagulant measure to use LMWH for preventing venous thromboembolism after the gastrointestinal surgery.