摘要
目的探讨利伐沙班与低分子肝素在静脉内热诱导血栓形成(EHIT)中的疗效与安全性差异。方法回顾性分析行静脉腔内激光消融术(EVLA)治疗的409例大隐静脉曲张患者临床资料,按照术后预防性抗凝方案的不同分为利伐沙班组(173例)和低分子肝素组(236例)。术后1周、4周复查患者下肢血管超声,比较两组患者在抗凝血栓事件与出血事件、住院时间与费用、患者满意度等方面的差异。结果两组患者EHIT分级情况、深静脉血栓(DVT)发生率比较,差异均无统计学意义(P均>0.05)。两组均无肺栓塞发生。利伐沙班组发生微小出血事件18例,低分子肝素组发生26例,两组微小出血事件发生率比较,差异无统计学意义(χ^(2)=0.04,P>0.05),且两组均无大出血事件发生。利伐沙班组平均住院时间明显低于低分子肝素组(t=5.21,P<0.05),两组住院费用比较,差异无统计学意义(t=0.45,P>0.05)。随访结果表明利伐沙班组患方满意度(99.42%)明显高于低分子肝素组(95.34%),差异有统计学意义(χ^(2)=5.84,P<0.05)。结论口服途径给予利伐沙班在预防EHIT、DVT与肺栓塞方面可获得不低于注射低分子肝素的效果,并且不会增加出血风险;此外,口服利伐沙班由于缩短了住院时间、避免皮下注射的痛苦等原因可明显提升患者的满意度。
Objective To investigate the efficacy and safety of new rivaroxaban versus LMWH for prevention of EHIT.Methods The clinical date of 409 patients with great saphenous varicose(GSV)who underwent endovenous laser abla⁃tion(EVLA)treatment were analyzed retrospectively.The patients were divided into rivaroxaban group and LMWH group.All patients were evaluated by ultrasound at 1 and 4 weeks after the operation.The thrombotic events,bleeding events,hospitalization time,hospitalization cost and patient satisfaction were compared between the two groups.Re⁃sults There was no significant differences in EHIT classification and incidence of DVT between the two groups(P>0.05).No patients had pulmonary embolism(PE).Minor bleeding events occurred in 18 of rivaroxaban group and 26 of LMWH group respectively,the difference was not statistically significant(χ^(2)=0.04,P>0.05).No major bleeding events were observed.The hospitalization time of the rivaroxaban group was lower than the LMWH group obviously(t=5.21,P<0.05).There was no difference in the hospitalization cost between the two groups(t=0.45,P>0.05).The patients sat⁃isfaction was higher in the rivaroxaban group when compared with the LMWH group(χ^(2)=5.84,P<0.05).Conclusion Rivaroxaban offers an oral medication approach showing no difference in preventing EHIT,DVT and PE compared with LMWH,without increased bleeding risk.Otherwise,it can improve the patients satisfaction for the reasons of lower hos⁃pitalization time and avoiding the pain of subcuta⁃neous injections.
作者
戴树龙
苏峥嵘
王先法
DAI Shulong;SU Zhengrong;WANG Xianfa(Department of General Surgery,Deqing People’s Hospital,Deqing 313200,China)
出处
《全科医学临床与教育》
2024年第5期408-410,共3页
Clinical Education of General Practice
基金
德清县科技计划项目(2021SK04)
浙江省医学会临床科研基金项目(2021ZYC-A143)。
