The Effect Of Low Molecular Weight Heparin Sodium On Bleeding And Embolization In Elderly Patients With Colorectal Cancer At Different Times

Objective:Hypercoagulable state and perioperative special conditions of patients with malignant tumors will destroy the balance of coagulation function.leading to thrombosis and even VTE and PE.Among them.the abdomen,especially in patients with lower abdominal malignant tumors,had the highest incidence of VTE during perioperative period.On the other hand.infection,bleeding and other problems are prone to perioperative period,and bleeding is contradictory to anticoagulant therapy.Therefore,the use of anticoagulant drugs in perioperative period for patients with colorectal malignancies is a subject worthy of study.This study aims to investigate the effects of low molecular weight heparin sodium on bleeding and embolism in patients with colorectal cancer at different stages of the perioperative period.Methods:Sixty patients with colorectal cancer in Dalian Friendship Hospital from January 2017 to October 2018 were enrolled in the study.The patients underwent radical resection of abdominal colorectal cancer.The patients were divided into three groups,subcutaneously injected with low molecular weight heparin sodium 12 hours before surgery.12 hours after surgery,and 24 hours after surgery.The amount of blood loss,postoperative blood loss,coagulation function,venous thrombosis of the lower extremities,or symptoms of VET and PT were counted.Statistical analysis was performed using SPSS 23.0 statistical software.Measurement data were expressed as mean ±standard deviation,single-factor Anova test:count data were analyzed by chi-square test.P<0.05 indicates that the difference was statistically significant.Results:(1)For intraoperative and postoperative bleeding problems:low molecular weight heparin sodium anticoagulation at different time periods during perioperative period,there was no significant difference in intraoperative and postoperative bleeding.(2)Coagulation function:The mean values of PLT.PT.TT and APTT in each group were within the normal range.and there was no significant difference between the groups.The mean INR increased from the normal value,but there was no significant difference between the groups.It can be seen that the use of anticoagulants at different times during the perioperative period has no significant effect on the changes of PT.TT.APTT and INR.Comparing the preoperative mean values,PLT was slightly reduced.and PT.TT.and APTT were prolonged.Comparing the D-D values between the three groups.it can be seen that D-D increased significantly after surgery.Low molecular weight heparin sodium was used 12 hours before surgery and 12 hours after surgery,,and had no significant effect on D-D.However,the use of anticoagulants 24 hours after surgery resulted in a significant increase in D-D values.It can be speculated that the use of anticoagulants 24 hours after surgery.the effect of anti-thrombosis is significantly less than the first two groups,will increase the risk of VTE.(3)The use of anticoagulant drugs 24 hours after surgery is insufficient to prevent perioperative embolization.Therefore,it is recommended to use anticoagulant drugs 12 hours before surgery or 12 hours after surgery.Conclusion:For patients with colorectal cancer,it is recommended to use low molecular weight heparin sodium anticoagulation 12 hours before surgery or 12 hours after surgery.The use of 24 hours after surgery is less effective in preventing embolism.