摘要
目的研究利伐沙班联用导管溶栓治疗急性下肢深静脉血栓的疗效及安全性。方法选取2015年6月到2017年5月间收治的急性下肢深静脉血栓患者50例,采取随机数字法将其分为对照组和观察组,各25例。对照组单纯给予导管溶栓治疗,在此基础上,观察组加服利伐沙班治疗。利用SPSS22. 0软件分析,血清炎症因子、凝血指标及治疗前后测量患肢周径计量资料以(x珋±s)表示,组间比较采用独立t检验;临床疗效比较、不良反应及复发率比较采用χ2检验,P <0. 05提示差异有统计学意义。结果观察组临床疗效96. 0%明显高于对照组72. 0%(χ2=5. 36,P=0. 02);治疗后,观察组血清炎症因子hs-CRP、IL-6、TNF-α均明显低于对照组(P <0. 01);观察组凝血指标D-D、FIB明显高于对照组(P <0. 01),而PT、APTT则低于对照组(P <0. 01);观察组膝上20 cm处、膝下15 cm处周径差值均明显低于对照组(P <0. 05);观察组治疗后6个月复发率显著低于对照组(χ2=5. 71,P=0. 02);此外,两组不良反应发生率差异无统计学意义(P> 0. 05)。结论利伐沙班联用导管溶栓治疗急性下肢深静脉血栓疗效确切,能够明显抑制机体炎症反应,改善患者凝血功能,预后良好且安全性较高,值得临床推广。
Objective To study the efficacy and safety of rivaroxaban combined with catheter thrombolysis in the treatment of acute lower extremity deep venous thrombosis. Methods 50 patients with acute lower extremity deep venous thrombosis were enrolled in our hospital from June 2015 to May 2017. 50 patients were divided into control group（treated with catheter thrombolysis, n =25）and observation group（treated with rivaroxaban and catheter thrombolysis, n =25）. Statistical analysis were performed by using SPSS 22.0 software, Measurement data such as serum inflammatory factors, coagulation parameters and measurement of limb circumference before and after treatment were expressed as mean±standard deviation and examined by using t -test. The clinical efficacy, adverse reactions and recurrence were compared by using chi square test. A P value of 〈0.05 was considered as statistically significant difference. Results The clinical efficacy of 96.00% in observation group was significantly higher than 72.00% in control group （χ 2=5.36 , P =0.02）. After treatment, The serum levels of hs-CRP, IL-6 and TNF-α in observation group were significantly lower than those control group respectively （ P 〈0.01）. The coagulation index DD and FIB in observation group were significantly higher than those in control group respectively （ P 〈0.01）. The levels of PT and APTT were lower than those in control group respectively （P 〈0.05）. The recurrence rate of observation group at 6 months after treatment was significantly lower than that in control group （χ 2=5.71,P =0.02） . In addition, there was no significant difference of adverse reaction rate between two groups （P 〉0.05）. Conclusion Rivaroxaban combined with catheter thrombolysis in the treatment of acute lower extremity deep venous thrombosis has a definite curative effect. It could inhibit the inflammatory reaction and improve the coagulation function of patients with good prognosis and safety. It is worthy of clinical promotion.
作者
刘军
林瑞敏
陈占
张军
张在兴
张玉林
Liu Jun;Lin Ruimin;Chen Zhan;Zhang Jun;Zhang Zaixing;Zhang Yu Lin(Department of General Surgery,Beijing haidian hospital,Beijing 100080,China;Liver Diseases Digestion Center,Beijing You＇an Hospital,Capital Medical University,Beijing 100069,China)
出处
《中华普外科手术学杂志（电子版）》
2018年第6期490-493,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家自然科学基金(81371399)
国家12.5重大科技专项基金(2012ZX10001-002
2012ZX10001-003
2012ZX10001-004)~~
