The Impact Of Hemorrhage And Coagulation On The Use Of Low-molecular-weight Heparin Started At Earlier Period After Lung Resection

ObjectiveLung cancer is one of the most common maligant tumor in China.Lung resction become a main type in thoracic surgery.Deep vein thrombosis even pulmonary embolism after major operations were reported again and again recently.There are dissensions for the routine use of low molecular weight heparin(LMWH) for patients undergoing major thoracic surgery. There are few literatures have recorded the impact of hemorrhage on the use of LMWH started at earlier period after lung resections.We will discuss whether the use of LMWH for thromboprophylaxis will increase the hemorrhage at the earlier period after lung resections and provide some imformation in such surgury in the future.MethodsWe randomly assigned 18 patients undergoing lung resections to anticoagulation group and non-anticoagulation group.The anticoagulation group received subcutaneous dose of LMWH(weight≥50kg,0.4ml;weight＜50kg, 0.3ml) once daily initiated at 6Am on the first day after surgery.Venous blood was collected to determine blood routine,coagulation function, liver and renal function before surgery.Arterial blood was collected to test TEG before anesthesia induction.Make blood routine and TEG test after surgery.Make blood routine test at 6Am on the first and second day after surgery.Make TEG at 9Am on the first day after surgery(3 hours after LMWH was used).Monitor the chest drainage.Data was statistically analysised by stata8.Use t-test to compare the difference.ResultsEach group had 9 patients.There are no differences in general states between the two groups.There are no difference in chest drainage each hour between two groups(P=0.14) 12-24 hours after surgery.After the use of LMWH,the chest drainage 24hour have no significant difference between two groups(P=0.68).On the comparison of TEG,there were also no difference.All the P value>0.05.The red blood cell count decreased(0.36±0.76)×10~9/L in anticoagulation group and(-0.18±0.22)×10~9/L in non-anticoagulation group after the use of LMWH.There was significant difference between the two groups(P=0.0001).There were no difference in Hb,Hct and Plt between two groups.The P values were 0.59,0.42,0.37.ConclusionThe use of LMWH for thromboprophylaxis initiated at the early period(12-24 hour) after lung resections didn't increase the risk of early bleeding.