低分子肝素钙联合利伐沙班对腹腔镜下全子宫切除术后下肢深静脉血栓形成的预防效果

Effectiveness of Low-molecular-weight Heparin Calcium Combined with Rivaroxaban in Prevention of Occurrence of Deep Vein Thrombosis of Lower Extremity in Patients after Total Laparoscopic Hysterectomy

目的探讨低分子肝素钙联合利伐沙班对腹腔镜下全子宫切除术后下肢深静脉血栓形成(DVT)的预防效果。方法回顾性分析2017年12月—2019年12月行腹腔镜下全子宫切除术106例的临床资料。根据术后抗凝药物方案分为观察组和对照组,每组53例。观察组给予低分子肝素钙联合利伐沙班治疗,对照组给予低分子肝素钙治疗。对比2组临床疗效,检测治疗前后凝血功能相关指标、腘静脉内径(POPV)及股浅静脉内径,观察DVT发生情况。结果观察组总有效率高于对照组(P<0.05)。2组治疗后凝血酶原时间(PT)、活化部分凝血酶时间(APTT)长于治疗前,纤维蛋白原(FIB)、D-二聚体(DD)低于治疗前(P<0.05);治疗后,观察组PT、APTT长于对照组,FIB、DD水平低于对照组(P<0.05,P<0.01)。治疗后3个月观察组POPV低于治疗前和对照组(P<0.05)。观察组DVT发生率低于对照组(P<0.05)。结论低分子肝素钙联合利伐沙班预防腹腔镜下全子宫切除术后下肢DVT疗效好,可显著改善凝血功能指标,并促进血液回流,有效降低DVT发生率,且安全性高。

Objective To explore the effectiveness of Low-molecular-weight Heparin Calcium combined with Rivaroxaban in prevention of occurrence of deep vein thrombosis(DVT)of lower extremity in patients after total laparoscopic hysterectomy(TLH).Methods Clinical data of 106 patients undergoing TLH between December 2017 and December 2019 was retrospectively analyzed,and the patients were divided into observation group and control group(n=53 in each group)according to the postoperative anticoagulant regimen.Observation group was treated with Low-molecular-weight Heparin Calcium combined with Rivaroxaban,while control group was treated with Low-molecular-weight Heparin Calcium.Clinical efficacy was compared,and coagulation-related indexes,popliteal vein diameter(POPV)and superficial femoral vein diameter before and after treatment were detected,and occurrence conditions of DVT were observed in two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,prothrombin time(PT)and activated partial thromboplastin time(APTT)were significantly longer,while levels of fibrinogen(FIB)and d-dimer(DD)were significantly lower than those before treatment in two groups(P<0.05).After treatment in observation group,PT and APTT were significantly longer,while levels of FIB and DD were significantly lower than those in control group(P<0.05,P<0.01).After treatment for 3 months,the POPV in observation group was significantly lower than that before treatment in the same group and in control group(P<0.05).The incidence rate of DVT in observation group was significantly lower than that in control group(P<0.05).Conclusion Low-molecular-weight Heparin Calcium combined with Rivaroxaban has good clinical effectiveness in preventing DVT of lower extremity in patients after TLH.It may significantly improve blood coagulation indexes,promote blood reflux and effectively reduce the incidence rate of DVT with good safety.