Notsuda Hirotsugu, Hoshikawa Yasushi, Sakurada Akira, Endo Chiaki, Maeda Sumiko, Watanabe Tatsuaki, Niikawa Hiromichi, Matsuda Yasushi, Noda Masafumi, Okada Yoshinori, Kondo Takashi
Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
Kyobu Geka. 2015 Apr;68(4):255-9.
Lung cancer patients with cardiovascular complications often require antithrombotic therapy. In this study, we discuss the present conditions and future problems associated with the perioperative management of such patients. We examined 36 lung cancer patients undergoing surgery who received antithrombotic therapy for cardiovascular complications. Twenty-one patients were administered unfractionated heparin in the perioperative period (heparin group). Fifteen patients were not administered unfractionated heparin in the perioperative period (no-heparin group). No significant intergroup differences were observed in operating time, intraoperative blood loss, duration of chest tube placement, and the number of hospitalization days. However, 2 serious cases of thromboembolism developed after surgery. One was a case of pulmonary thromboembolism and the other was one of superior mesenteric artery thromboembolism. These results suggest that the appropriate perioperative usage of heparin enables the standard surgical treatment of lung cancer patients with cardiovascular complications. We recommend the use of low-molecular-weight heparin or low-dose unfractionated heparin as the antithrombotic agent after lung cancer surgery.
患有心血管并发症的肺癌患者通常需要抗血栓治疗。在本研究中,我们讨论了此类患者围手术期管理的现状及未来问题。我们检查了36例接受心血管并发症抗血栓治疗的肺癌手术患者。21例患者在围手术期接受了普通肝素治疗(肝素组)。15例患者在围手术期未接受普通肝素治疗(无肝素组)。在手术时间、术中出血量、胸管放置时间和住院天数方面,未观察到组间有显著差异。然而,术后发生了2例严重血栓栓塞病例。1例为肺血栓栓塞,另1例为肠系膜上动脉血栓栓塞。这些结果表明,围手术期合理使用肝素能够对患有心血管并发症的肺癌患者进行标准的手术治疗。我们建议在肺癌手术后使用低分子量肝素或小剂量普通肝素作为抗血栓药物。