气压治疗联合利伐沙班对结直肠癌术后下肢深静脉血栓的防治作用

Efficacy of pneumatic compression therapy combined with rivaroxaban for the prevention and treatment of deep venous thrombosis in the leg after surgery for colorectal cancer

目的探讨气压治疗联合利伐沙班对结直肠癌术后下肢深静脉血栓的防治作用。方法选取2018年2月至2019年5月间武汉市第一医院收治的82例手术治疗的结直肠癌患者。根据治疗方法不同进行分组,采用利伐沙班治疗的41例患者纳入对照组,采用气压治疗联合利伐沙班治疗的41例患者纳入观察组。比较两组患者下肢深静脉血栓发生情况、血流动力学指标、治疗前后凝血指标和术后并发症发生率。结果观察组患者下肢深静脉血栓发生率为4.9%,低于对照组患者的19.5%,差异有统计学意义(P <0.05)。观察组患者治疗后左右两侧腘静脉、股静脉和髂静脉平均血流速度均大于对照组患者,差异有统计学意义(P <0.05)。治疗前,两组患者D-二聚体(D-D)、纤维蛋白原(Fib)、活化部分凝血活酶时间(APTT)和凝血酶原时间(PT)比较,差异无统计学意义(P>0.05)。两组患者治疗后D-D和Fib水平较治疗前升高,且观察组低于对照组,差异均有统计学意义(均P <0.05)。两组患者治疗后APTT和PT较治疗前延长,且观察组长于对照组,差异均有统计学意义(均P <0.05)。观察组患者并发症发生率为4.9%,低于对照组患者的22.0%,差异有统计学意义(P <0.05)。结论在结直肠癌术后下肢深静脉血栓的防治中,气压治疗联合利伐沙班可以增加静脉血液流速,调节凝血因子水平,降低并发症发生率。

Objective To investigate the efficacy of pneumatic compression therapy combined with rivaroxaban for the prevention and treatment of deep venous thrombosis in the leg after surgery for colorectal cancer. Methods A total of 82 patients who underwent surgery for colorectal cancer at First Hospital of Wuhan from February 2018 to May 2019 were selected. They were divided into an observation group and a control group with 41 patients in each group according to the random number table. The observation group was treated with pneumatic compression therapy combined with rivaroxaban and the control group was only given rivaroxaban. The incidence of deep vein thrombosis in the leg,hemodynamic index,coagulation index before and after treatment and the incidence of postoperative complications were compared between the two groups. Results The incidence of deep venous thrombosis in the leg 4. 9% in the observation group was which was lower than 19. 5% of the control group( P < 0. 05). The mean blood flow velocity of popliteal vein,femoral vein and iliac vein was higher in the observation group than in the control group( all P <0. 05). Before the treatment,there was no significant difference in D-dimer( D-D) and fibrinogen( FIB),activated partial thromboplastin time( APTT) and prothrombin time( PT) between the two groups( P >0. 05). After the treatment,D-D and FIB increased in both groups with the observation group lower than in the control group( all P < 0. 05). APTT and PT were prolonged in both groups with the observation group longer than in the control group( all P < 0. 05). The incidence of complications was 4. 9% in the observation group which was lower than 22. 0% of the control group( P < 0. 05). Conclusion In the prevention and treatment of deep venous thrombosis in the lower limb after surgery for colorectal cancer,pneumatic compression therapy combined with rivaroxaban can increase venous blood flow rate,regulate D-D and FIB levels,and reduce the incidence of complications.