利伐沙班预防肿瘤化疗患者PICC相关性上肢深静脉血栓形成的研究  

Prevention of PICC-associated Upper Extremity Deep Vein Thrombosis by Rivaroxaban in Patients with Tumor Chemotherapy

作　　者：黄懿华 郁美珍 黄峥 罗翠松 HUANG Yihua;YU Meizhen;HUANG Zheng;LUO Cuisong(Department of General Surgery,Zhuhai Integrated Traditional Chinese and Western Medicine Hospital(Zhuhai Hospital Affiliated to Southern Medical University),Zhuhai,Guangdong Province,519000 China;Department of Medical Record Room,Zhuhai Hospital of Guangdong Hospital of Traditional Chinese Medicine,Zhuhai,Guangdong Province,519000 China)

机构地区：[1]珠海市中西医结合医院(南方医科大学附属珠海医院)普通外科,广东珠海519000 [2]广东省中医院珠海医院病案室,广东珠海519000

出　　处：《中外医疗》2023年第13期102-105,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨利伐沙班对预防经外周置入中心静脉导管相关性上肢深静脉血栓形成(peripherally inserted central venous catheter-related deep venous thrombosis, PICC-related DVT)的有效性及安全性。方法 方便选取2019年1月—2022年3月珠海市中西医结合医院和广东省中医院珠海医院96例因化疗需要行PICC置管的恶性肿瘤患者,随机分为治疗组及对照组,每组48例,治疗组口服利伐沙班20 mg/d,对照组给予常规处理。PICC置管后1周、2周、4周、8周对入组患者导管所在侧上肢深静脉进行彩色多普勒超声检查,观察是否发生PICC-related DVT及出血等不良反应。结果 置管8周后,治疗组PICC-related DVT发生率为2.1%,低于对照组的16.7%,差异有统计学意义(χ^(2)=4.414,P<0.05)。两组均未发生死亡、肺栓塞、严重大出血和提前拔管事件。结论 预防服用利伐沙班可显著降低PICC-related DVT的发生率。Objective To investigate the efficacy and safety of rivaroxaban in preventing peripherally inserted central venous catheterrelated deep venous thrombosis(PICCrelated DVT).Methods From January 2019 to March 2022,96 patients with malignant tumors who needed PICC catheterization due to chemotherapy in Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine and Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine were conveniently selected randomly divided into treatment group and control group,with 48 cases in each group.The treatment group was given oral rivaroxaban 20 mg/d,while the control group was given routine treatment.Color Doppler ultrasonography was performed on the deep veins of the upper limbs of the patients in the group at 1 week,2 weeks,4 weeks and 8 weeks after PICC catheterization to observe whether PICCrelated DVT and bleeding occurred.Results After 8 weeks of catheterization,the incidence of PICCrelated DVT in the control group was 2.1%,lower than 16.7%in the control group,and the difference was statistically significant(χ^(2)=4.414,P<0.05).No death,pulmonary embolism,severe bleeding and early extubation occurred in both groups.Conclusion Prophylactic use of rivaroxaban significantly reduced the incidence of PICCrelated DVT.

关 键 词：上肢深静脉血栓形成 利伐沙班 经外周置入中心静脉导管 

分 类 号：R4[医药卫生—临床医学]