Low-molecular-weight Heparin and Salvia Miltiorrhiza Injection in Prevention of Deep Venous Thrombosis after Rectal Cancer Surgery: a Prospective Randomized Controlled Trial
JI Lie-chen,GU Li-qiang,WANG Juan
Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin (300121), China
Abstract:
Objective To study the efficacy and safety of low-molecular-weight heparin and Salvia miltiorrhiza injection in preventing deep venous thrombosis after rectal cancer operation. Methods Totally 200 patients who underwent radical resection of rectal cancer were divided into 4 groups randomly, such as control group with 5% Glucose Injection (diabetes mellitus with regular insulin proportionally), Salvia miltiorrhiza injection group (group 1), low-molecular-weight heparin group (group 2), and low-molecular-weight heparin combined with Salvia miltiorrhiza injection group (group 3), with 50 cases in each group, and all patients were treated with laparoscopic operation by the same physician. The statistics of general information, surgical data, and blood coagulation parameters were measured preoperative and postoperative 3 d and 7 d after operation were recorded in 4 groups. The number of patients with DVT and bleeding tendency after operation were counted. Results The PLT, PT, APTT, TT indexes of groups 1, 2 and 3 were not signifificant compared with those of control group (P>0. 05). There was no significant difference in FIB and D-D between group 1 and control group 3 and 7 d after operation (P>0.05). FIB (6.71±1.87) g/L and D-D (1.14±0.79) mg/L in 3 d after operation, FIB (5.18±2.37) g/L and D-D (0.98±0.63) mg/L in 7 d after operation in group 2 were lower than those in the control group after 3 d [FIB (8.78±1.02) g/L and D-D (1.69±0.35) mg/L], after 7 d [FIB (5.18±2.37) g/L and D-D group (0.98±0.63) mg/L] and group 1 after 3 d [FIB (7.83±0.95) g/L and D-D (1.58±0.51) mg/L], after 7d [FIB (6.89±1.58) g/L and D-D (1.21±0.28) mg/L], with statistically significant difference (P<0.05). In group 3, the indexes postoperative 3 d [FIB (4.89±2.51) g/L and D-D (0.67±0.34)mg/L], 7 d after operation [FIB (3.38±0.95) g/L and D-D (0.47±0.25) mg/L] were lower than those in the control group, group 1 and group 2 postoperative 3d and 7 d after operation, with statistically signifificant difference (P<0.05). There was only 1 case of DVT in group 3 after operation, there was signifificant difference compared with control group (8 cases), group 1 (7 cases) and group 2 (4 cases) (P<0.05). There was no signifificant difference among the four groups in terms of bleeding in other parts after operation (P>0.05). Conclusion Low-molecular-weight heparin combined with Salvia miltiorrhiza injection can signifificantly prevent the occurrence of DVT after rectal cancer surgery.
