摘要
目的观察比较利伐沙班与依诺肝素预防腰椎术后下肢深静脉血栓(DVT)的效果。方法选取我院100例择期腰椎手术的DVT高危患者,随机分为利伐沙班组(A组,50例)和依诺肝素组(B组,50例)。分别于术后6 h和12 h开始口服利伐沙班和注射依诺肝素;均于患者能下床活动后停药。分别于术前和术后7 d检测血D-二聚体,记录凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)。术后记录48 h引流量,术后7 d行双下肢血管超声检查。结果两组患者均无明显的下肢DVT形成和肺栓塞发生。A组术后48 h的引流量,术后7 d肌肉静脉血栓发生率及D-二聚体、PT、APTT的水平较B组差异均无统计学意义(P>0.05),且均无切口周围血肿、消化道出血、硬膜外血肿等不良反应发生。结论利伐沙班预防腰椎术后下肢DVT形成的效果与依诺肝素相当,且安全有效。
Objective To observe the effects of rivaroxaban and enoxaparin on preventing deep venous thrombosis（ DVT） after lumbar surgery. Methods 100 high-risk cases with DVT undergoing elective lumbar spine surgery in our hospital were selected and randomly divided into rivaroxaban group（ group A,n = 50） and enoxaparin group（ group B,n = 50）. Patients in both groups were orally administrated with rivaroxaban and enoxaparin at 6 hours and 12 hours perceptively until all the patients could walk off bed. The levels of D-dimer,PT and APTT in blood were detected 7days before and after the operation perceptively. Drainages volumes of 48 hours after the operation were recorded.Double lower extremity vascular ultrasound was performed 7 days after the operation. Results No significant formations of lower extremity DVT and pulmonary embolism were noted. There was no significant difference in drainages at48 hours,incidence of muscular veniplex thrombosis at 7 days after the operation,and the levels of D-dimer,PT and APTT between group A and group B（ P〉0. 05）. No adverse events,such as hematoma around the incision,gastrointestinal bleeding,epidural hematoma were observed. Conclusion Rivaroxaban and enoxaparin have the same effects on preventing DVT after lumbar surgery and they are found to be safe and effective.
出处
《实用药物与临床》
CAS
2015年第1期39-42,共4页
Practical Pharmacy and Clinical Remedies
