不同剂量利伐沙班治疗肿瘤患者经外周静脉穿刺的中心静脉导管术相关性导管外血栓的疗效与安全性分析  

Clinical efficacy and safety analysis of different rivaroxaban doses in treating tumor patients with peripherally inserted central venous catheter related extra catheter thrombosis

作　　者：陈康彪[1] 叶妍妍 吴业 劳逸[1] 黄潞[1] 林锟[2] CHEN Kangbiao;YE Yanyan;WU Ye;LAO Yi;HUANG Lu;LIN Kun(Fourth Department of Medical Oncology,Guangdong Agriculture Reclamation Central Hospital,Zhanjiang 524000,Guangdong,China;Burn Plastic Surgery,Guangdong Agriculture Reclamation Central Hospital,Zhanjiang 524000,Guangdong,China)

机构地区：[1]广东省农垦中心医院肿瘤内科四区,广东湛江524000 [2]广东省农垦中心医院烧伤整形外科,广东湛江524000

出　　处：《癌症进展》2021年第24期2537-2539,2558,共4页Oncology Progress

基　　金：湛江市科技计划项目(2020B01264)。

摘　　要：目的探讨不同剂量利伐沙班治疗肿瘤患者经外周静脉穿刺的中心静脉导管术(PICC)相关性导管外血栓的疗效与安全性。方法将60例PICC相关性导管外血栓患者采用随机数字表法分为观察组和对照组,每组30例。观察组口服利伐沙班10 mg,每日2次,连续3周后改为10 mg,每日1次;对照组口服利伐沙班15mg,每日2次,连续3周后改为20 mg,每日1次。比较两组患者的血栓治疗有效率、血栓缓解时间、治疗前后凝血指标变化、不良事件发生率及医疗费用。结果治疗后,两组患者的D-二聚体(D-D)、纤维蛋白原(FIB)均降低(P﹤0.05),但两组间比较差异无统计学意义(P﹥0.05)。观察组患者的不良事件总发生率、医疗费用均低于对照组(P﹤0.05);两组患者的治疗有效率、血栓缓解时间比较,差异均无统计学意义(P﹥0.05)。结论低剂量与常规剂量利伐沙班治疗肿瘤PICC相关性导管外血栓患者均具有较好的治疗效果和较高的安全性,因此,临床上多采用低剂量利伐沙班进行治疗,可减少医疗费用支出,具有良好的社会效益和经济效益。Objective To investigate the clinical efficacy and safety of different rivaroxaban doses in the treatment of tumor patients with peripherally inserted central venous catheter(PICC)related extra-catheter thrombosis.Method A to-tal of 60 patients with PICC related extra-catheter thrombosis were randomly divided into observation group and control group,30 cases in each group.The observation group was given rivaroxaban 10 mg twice a day,orally for 3 weeks,then changed to 10 mg,once a day;the control group was orally administered rivaroxaban 15 mg twice per day for 3 weeks,and then changed to 20 mg once a day.The objective response rate of thrombosis treatment,thrombosis remission time,changes of coagulation indicators before and after treatment,the incidence of adverse events,and medical expenses were compared between the two groups.Result After the treatment,D-dimer(D-D)and fibrinogen(FIB)in both groups were decreased(P<0.05),but there were no significant differences between the two groups(P>0.05).The total incidence of ad-verse events and medical expenses in the observation group were lower than those of the control group(P<0.05).There were no significant differences in the objective response rate and thrombosis remission time between the two groups(P>0.05).Conclusion Both low-dose and conventional-dose rivaroxaban could obtain good therapeutic effects with high safety in the treatment of patients with tumor PICC related extra-catheter thrombosis.Therefore,low-dose rivaroxaban should be recommended more commonly in clinical treatment,which could bring good social and economic benefits.

关 键 词：利伐沙班 经外周静脉穿刺的中心静脉导管术 血栓 临床疗效 安全性 

分 类 号：R730[医药卫生—肿瘤]