利伐沙班联合经腘静脉穿刺导管吸栓、溶栓治疗下肢深静脉血栓的效果及其对凝血因子水平的影响

Effect of rivaroxaban combined with transpopliteal venous puncture catheter aspiration and thrombolysis in the treatment of lower extremity deep vein thrombosis and its impact on coagulation factor levels

目的探讨利伐沙班联合经腘静脉穿刺导管吸栓、溶栓治疗下肢深静脉血栓的效果及其对凝血因子水平的影响。方法选取2019年10月至2022年5月南京市溧水区人民医院就诊的90例下肢深静脉血栓患者,按照随机数字表法将其分为对照组(n=45,经腘静脉穿刺导管吸栓、溶栓治疗)和观察组(n=45,在对照组基础上加用利伐沙班)。比较两组患者治疗2周后的临床疗效,比较两组患者治疗前后的患肢肿胀值、凝血因子水平,记录两组患者治疗期间不良反应发生情况。结果观察组患者总有效率为95.56%(43/45),高于对照组患者的82.22%(37/45),差异有统计学意义(P﹤0.05)。治疗后,两组患者患侧大腿、小腿肿胀值均低于本组治疗前,且观察组患者患侧大腿、小腿肿胀值均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者FⅡ、FⅤ、FⅧ水平均低于本组治疗前,且观察组患者FⅡ、FⅤ、FⅧ水平均低于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者不良反应发生率为13.33%(6/45),与对照组患者的8.89%(4/45)比较,差异无统计学意义(P﹥0.05)。结论利伐沙班联合经腘静脉穿刺导管吸栓、溶栓能有效提高下肢深静脉血栓治疗效果,缓解患肢肿胀情况,改善凝血因子水平,且未明显增加不良反应,值得临床推广。

Objective To investigate the clinical effect of rivaroxaban combined with transpopliteal venous puncture catheter aspiration and catheter thrombolysis in the treatment of lower extremity deep vein thrombosis and its impact on coagulation factor levels.Method A total of 90 patients with deep vein thrombosis of the lower extremity from October 2019 to May 2022 were selected from Nanjing Lishui People's Hospital.According to the random number table method,they were divided into control group(n=45,transpopliteal venous puncture catheter aspiration and thrombolysis therapy)and observation group(n=45,rivaroxaban added to the control group).The clinical efficacy after treatment two weeks were compared,the swelling value of the affected limb and the levels of coagulation factors of the two groups before and after the treatment were compared.The occurrence of adverse events of two groups were recorded.Result The total effective rate of patients in the observation group was 95.56%(43/45),higher than that of 82.22%(37/45)in the control group,the difference was statistically significant(P<0.05).After treatment,the swelling values of the thigh and calf on the affected side of the two groups were lower than those before treatment,the swelling values of the affected thigh and calf of the patients in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After treatment,the levels of FII,FV,and FVIII in two groups were lower than those before treatment,the levels of the foregoing indexes in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of adverse events in the observation group was 13.33%(6/45),compared with 8.89%(4/45)in the control group,the difference was not statistically significant(P>0.05).Conclusion Rivaroxaban combined with transpopliteal venous puncture catheter aspiration and thrombolysis could effectively improve the treatment effect of lower extremity deep vein thrombosis,relieve the swelling of the affected limb,and improve the level of coagulation factors,the method dose not increase the risk of adverse events,which is worthy of clinical promotion.