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目的：探讨胰腺癌患者术后进行血栓预防的必要性及预防性应用低分子肝素预防血栓的有效性。方法：２６ 例胰腺癌患者随机分为对照组１０ 例、试验组１６ 例，试验组术后第１天开始预防性应用低分子肝素５ ０００ Ｕ／ｄ×７ ｄ，两组于术前３ ｄ、术后２ 周分别测定血液流变学及凝血指标。结果：２６例胰腺癌患者术前全血还原粘度低切（１７．０６±７．３４） ｍ Ｐａ·ｓ，高切（５．７３±３．５５） ｍ Ｐａ·ｓ均为正常值上限；其中有３例低切＞ ２２．５３ ｍ Ｐａ·ｓ，高切＞ ８．３６ ｍ Ｐａ·ｓ，占１１．５％ 。术后对照组低切（２１．８２±６．１７） ｍ Ｐａ·ｓ，高切（８．６２±３．４８） ｍ Ｐａ·ｓ，１例出现静脉血栓，占３．８％ ；术后试验组低切（１３．１１±５．１７） ｍ Ｐａ·ｓ，高切（４．９６±３．６１） ｍ Ｐａ·ｓ，与对照组相比差异显著（Ｐ＜ ０．０５），试验组无１例发生出血等副作用。结论：胰腺癌患者术前、术后血液粘滞度普遍升高，术后较术前更明显。预防性应用低分子肝素能有效降低血液粘滞度、预防静脉血栓的发生。
Objective: To investigate the necessity of postoperative thromboprophylaxis in patients with pancreatic cancer and the effectiveness of prophylactic application of low molecular weight heparin in the prevention of thrombosis. Methods: Twenty-six patients with pancreatic cancer were randomly divided into control group (10 cases) and experimental group (16 cases). The experimental group began to use low-molecular-weight heparin (5 000 U/d x 7 d) on the first postoperative day. The two groups were preoperative for 3 days. Hemorheology and coagulation parameters were measured at 2 weeks postoperatively. Results: In 26 patients with pancreatic cancer, preoperative whole blood reduced viscosity was low (17.06 ± 7.34) m Pa · s, and high (5.73 ± 3.55) m Pa · s was the upper limit of normal; Among them, there were 3 cases of low cut> 22.53 mPa·s, high cut> 8.36 mPa·s, accounting for 11.5%. After operation, the control group had low-cut (21.82±6.17) m Pa·s, high-cut (8.62±3.48) m Pa·s, and one case had venous thrombosis, accounting for 3.8%; In the experimental group, low-cut (13.11±5.17) m Pa·s and high-cut (4.96±3.61) m Pa·s were significantly different from the control group (P<0.05). No side effects such as bleeding occurred in the group. Conclusion: The preoperative and postoperative blood viscosity of pancreatic cancer patients generally increased, and postoperatively was more obvious than before surgery. Preventive application of low molecular weight heparin can effectively reduce blood viscosity and prevent the occurrence of venous thrombosis.