对比不同抗凝治疗在下肢静脉曲张术后预防深静脉血栓的疗效分析  

Comparison of the effects of different anticoagulation treatments on prevention of deep vein thrombosis after varicose vein surgery

作　　者：薛亚斌 彭佳玄 沈冬冬 XUE Yabin;PENG Jiaxuan;SHENG Dongdong(Department of General Surgery,the First Affiliated Hospital of Henan Polytechnic University,Jiaozuo Henan 454000,China)

机构地区：[1]河南理工大学第一附属医院血管外普外三区,河南焦作454000

出　　处：《临床研究》2021年第5期5-7,共3页Clinical Research

摘　　要：目的探讨低分子肝素、吲哚布芬与利伐沙班在下肢静脉曲张伴血栓性浅表静脉炎术后预防深静脉血栓的临床疗效。方法回顾性分析河南理工大学第一附属医院2015年1月至2019年12月的大隐静脉曲张伴血栓性浅表静脉炎患者122例,所有患者均行下肢大隐静脉高位结扎剥脱术,按术后给予抗凝药物的不同将患者分为低分子肝素组41例、吲哚布芬组36例与利伐沙班组45例,比较三组患者术后出血及深静脉血栓发生情况。结果三组患者下肢深静脉血栓发生率比较,无显著差异(P>0.05);术后低分子肝素组皮下淤血/瘀斑高于其他两组,差异具有统计学意义(P<0.05);而利伐沙班组术后出血倾向发生率高于低分子肝素组及吲哚布芬组,差异无统计学差异(P>0.05)。结论三组治疗方案均可以有效预防下肢静脉曲张伴血栓性浅表静脉炎术后深静脉血栓形成,但利伐沙班及吲哚布芬在皮下出血及血肿发生率低于低分子肝素组。Objective To explore the clinical efficacy of low molecular weight heparin,indobufen and rivaroxaban in the prevention of deep vein thrombosis after surgery for lower extremity varicose veins with thrombotic superficial phlebitis.Methods A retrospective analysis of 122 patients with saphenous varicose veins and thrombotic superficial phlebitis from the first affiliated hospital of Henan Polytechnic University from January 2015 to December 2019,all patients underwent high ligation and stripping of the saphenous vein of the lower extremities.According to the different anticoagulant drugs given after operation,the patients were divided into 41 cases in the low molecular weight heparin group,36 cases in the indobufen group and 45 cases in the rivaroxaban group.The postoperative bleeding and deep vein thrombosis in the three groups were compared.Results The incidence of lower limb deep vein thrombosis in the three groups was not statistically significant(P>0.05);the subcutaneous congestion/ecchymosis in the postoperative low molecular weight heparin group was higher than that in the other two groups,the difference was statistically significant(P<0.05);The incidence of postoperative bleeding tendency in the saban group was higher than that in the low molecular weight heparin group and the indobufen group,but the difference was not statistically significant(P>0.05).Conclusion The three treatment schemes can effectively prevent the formation of deep vein thrombosis after varicose veins with thrombotic superficial phlebitis,but the incidence of subcutaneous bleeding and hematoma in rivaroxaban and indobufen is lower than that in the low molecular heparin group.

关 键 词：大隐静脉曲张 浅表静脉炎 低分子肝素 吲哚布芬 利伐沙班 下肢深静脉血栓 

分 类 号：R654.4[医药卫生—外科学]