利伐沙班与华法林治疗老年单纯下肢肌间静脉血栓的临床效果对比

Comparison of Clinical Effects of Rivaroxaban and Warfarin in the Treatment of Elderly Patients with Simple Lower Limb Intermuscular Venous Thrombosis

目的:对比利伐沙班与华法林治疗老年单纯下肢肌间静脉血栓(IVTLE)的临床效果。方法:回顾性分析2018年1月-2020年12月重庆三峡医药高等专科学校附属人民医院收治的126例老年单纯IVTLE患者的临床资料。54例采用利伐沙班治疗的患者作为利伐沙班组,72例采用华法林治疗的患者作为华法林组。比较两组治疗前与治疗15 d、1个月、3个月后临床症状评分和体征评分;比较两组治疗不同时间的血栓消失率;比较两组国际标准化比值(INR)达标率、不良反应发生情况和满意情况。结果:两组治疗前、治疗15 d、1个月和3个月后临床症状评分及体征评分均逐渐降低(P<0.05)。两组治疗15 d、1个月、3个月后临床症状评分、体征评分、血栓消失率和INR达标率比较,差异均无统计学意义(P>0.05);与华法林组比较,利伐沙班组不良反应发生率降低,患者满意度升高,差异均有统计学意义(P<0.05)。结论:利伐沙班与华法林在老年单纯IVTLE治疗中均有确切效果。与华法林相比,利伐沙班不良反应发生率更低,患者满意度更高,值得临床推广。

Objective:To compare the clinical effects of Rivaroxaban and Warfarin in the treatment of simple lower extremity intermuscular venous thrombosis (IVTLE) in the elderly.Method:The clinical data of 126 elderly patients with simple IVTLE admitted to the Affiliated People’s Hospital of Chongqing Three Gorges Medical College from January 2018 to December 2020 were retrospectively analyzed.Fifty-four patients treated with Rivaroxaban were assigned to the Rivaroxaban group and 72 patients treated with Warfarin were assigned to the Warfarin group.The clinical symptom and sign scores of the two groups were compared before treatment and at 15 d,1 month and 3 months after treatment.The rate of thrombus disappearance was compared between the two groups.The rate of international standardized ratio (INR),incidence of adverse reactions and satisfaction of the two groups were compared.Result:Clinical symptom score and sign score of both groups decreased gradually before treatment,15 d,1 month and 3 months after treatment (P<0.05).There were no significant differences in clinical symptom score,sign score,thrombosis disappearance rate after 15 d,1 month and 3 months of treatment and INR compliance rate between the two groups (P>0.05).Compared with Warfarin group,the incidence of adverse reactions in Rivaroxaban group was lower and patient satisfaction was higher,with statistical significance (P<0.05).Conclusion:Both Rivaroxaban and Warfarin are effective in the treatment of elderly patients with simple IVTLE.Compared with Warfarin,Rivaroxaban has lower incidence of adverse reactions and higher patient satisfaction,which is worthy of clinical promotion.