中文摘要：

目的：探讨围术期肺功能康复训练联合低分子肝素防治胸外科患者术后急性肺栓塞的效果。方法选取2013年2月至2015年2月陕西省榆林市第一医院胸心外科患者共154例，将患者随机分为试验组（n＝79）和对照组（n＝75）。对照组给予围手术期肺功能康复训练；试验组在对照组基础上，于术后1～7 d ，皮下注射低分子肝素0.4 mL。记录两组术后心电监护时间、引流管留置时间、胸腔引流量和住院时间，术前及术后7 d检测肺功能[用力肺活量（FVC ）、第1秒用力呼气量（FEV1）、第1秒用力呼气量占预计值百分比（FEV1％）]、凝血酶时间（PT）、纤维蛋白原（Fib）、血小板计数（PLT）和D‐二聚体（D‐D），以及两组术后肺部并发症、急性PE发生率和不良用药反应。结果两组术后心电监护时间、引流管留置时间、胸腔引流量、住院时间、肺功能指标及肺部并发症差异无统计学意义（P＞0.05）；试验组术后Fib、D‐D明显低于对照组（P＜0.05），而PT、PLT差异无统计学意义（P＞0.05）；试验组术后急性PE发生率明显低于对照组（P＜0.05）；试验组中，注射部位硬结2例，注射部位皮下出血1例，牙龈出血1例，经针对性处理后，症状缓解或消失，未对临床治疗造成影响。结论围术期肺功能康复训练联合低分子肝素可降低Fib、D‐D水平，预防急性PE发生。

英文摘要：

Objective To investigate the effect of perioperative pulmonary function rehabilitation training combined with low molecular weight heparin on the prevention and treatment of acute pulmonary embolism in patients after thoracic surgical operations . Methods 154 cases of patients who underwent thoracic surgical operations between February of 2013 and February of 2015 were selected as study subjects and were randomized into the experiment group （79 cases） and the control group （75 cases） .The control group received the perioperative pulmonary rehabilitation training .The experiment group was treated with the same training and the subcutaneous injection of 0 .4ml low molecular weight heparin during the first 7 days after operations .The postoperative ECG monitoring time ,drainage tube indwelling time ,chest drainage volume and hospitalization time of the two groups were recorded .The pulmonary functions such as forced vital capacity （FVC ） ,forced vital capacity in 1 second （FEV1） ,ratio of FEV1 to predicated value （FEV1/PV） ,thrombin time （PT） ,fibrinogen （FIB） ,platelet count （PLT） and D‐Dimer （D‐D） were detected before operations and on the 7th day after operations .The incidence rates of pulmonary complications ,acute pulmonary embolism and adverse drug reactions in the two groups were recorded . Results There were no significant differences between the two groups in postoperative ECG monitoring time , drainage tube indwelling time , chest drainage volume , hospitalization time , pulmonary function indexes andpulmonary complications （P〉0.05） .FIB and D‐D in the experiment group were significantly lower than those in the control group after operations （P〈0.05） ,but PLT and PT were not significantly different between the groups （P〉0.05） .The incidence rate of postoperative acute pulmonary embolism was significantly lower in the experiment group than in the control group （ P〈 0.05 ） . There were 2 cases with injection‐site induration , 1 case with su