利伐沙班治疗下肢深静脉血栓的疗效观察

Observation on efficacy of rivaroxaban on the treatment of deep venous thrombosis of lower extremity

目的探讨利伐沙班治疗下肢深静脉血栓的临床疗效及安全性。方法 79例下肢静深脉血栓患者,根据治疗方法的不同分为利伐沙班组(42例)与华法林组(37例)。观察比较两组患者住院时间、患肢肿痛消退时间、D二聚体下降幅度、血栓变化以及不良反应发生情况。结果利伐沙班组患者D二聚体下降幅度(60.1±24.3)%略低于华法林组的(67.3±21.5)%,差异无统计学意义(P>0.05)。利伐沙班组患者住院时间(11.5±5.3)d短于华法林组的(14.4±6.1)d,但差异有统计学意义(P<0.05)。利伐沙班组患肢肿痛消退时间(9.1±4.0)d略短于华法林组的(10.3±4.2)d,但差异无统计学意义(P>0.05)。利伐沙班组静脉通畅率71.4%略高于华法林组的64.9%,但差异无统计学意义(P>0.05)。利伐沙班组出血发生率7.1%显著低于华法林组的24.3%,差异有统计学意义(χ~2=4.508, P<0.05)。结论利伐沙班治疗下肢深静脉血栓安全有效,可缩短患者住院时间、降低出血发生风险。

Objective To discuss the clinical efficacy and safety of rivaroxaban on the treatment of deep venous thrombosis of lower extremity. Methods A total of 79 patients with deep venous thrombosis of lower extremity were divided by different treatment methods into rivaroxaban group(42 cases) and warfarin group(37 cases). Observation were made on hospitalization time, extremity swelling and pain subsidence time, D-dimer decline range, thrombosis changes and occurrence of adverse reactions between the two groups. Results Rivaroxaban group had lower D-dimer decline range as(60.1±24.3)% than(67.3±21.5)% in warfarin group, but the difference was not statistically significant(P >0.05). Rivaroxaban group had shorter hospitalization time as(11.5±5.3) d than(14.4±6.1) d in warfarin group, and the difference was statistically significant(P<0.05). Rivaroxaban group had a little shorter swelling regression time of affected limb as(9.1±4.0) d than(10.3±4.2) d in warfarin group, but the difference was not statistically significant(P >0.05). Rivaroxaban group had a little higher venous patency rate as 71.4% than 64.9% in warfarin group, but the difference was not statistically significant(P >0.05). Rivaroxaban group had significantly lower incidence of bleeding as 7.1% than 24.3% in warfarin group, and the difference was statistically significant(χ^2=4.508, P<0.05). Conclusion Rivaroxaban is safe and effective in the treatment of deep venous thrombosis of lower extremities, and can shorten hospitalization time and reduce the risk of bleeding.