预防性干预流程联合利伐沙班对脊柱外科术后下肢深静脉血栓的影响  

Effect of preventive intervention process combined with rivaroxaban on lower extremity deep vein thrombosis after spinal surgery

作　　者：高新雪 黄洁[1] 韩莹[1] 王惠婷 张蕴鑫 Gao Xinxue;Huang Jie;Han Ying;Wang Huiting;Zhang Yunxin(Department of Spinal Surgery,Beijing Jishuitan Hospital,Beijing 100032,China;Department of Vascular Surgery,Beijing Jishuitan Hospital,Beijing 100032,China)

机构地区：[1]北京积水潭医院脊柱外科,北京100032 [2]北京积水潭医院血管外科,北京100032

出　　处：《血管与腔内血管外科杂志》2023年第5期561-564,584,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨预防性干预流程联合利伐沙班对脊柱外科术后下肢深静脉血栓的影响。方法收集2019年1月至2021年12月于北京积水潭医院进行手术治疗的100例脊柱疾病患者的临床资料,根据是否围手术期接受预防性干预流程管理将患者分为干预组(n=43)和对照组(n=57)。两组患者围手术期均接受常规管理,术后均使用利伐沙班预防下肢深静脉血栓,而干预组患者在此基础上接受预防性干预流程管理。比较两组患者的术后下肢深静脉血栓发生情况、术后D-二聚体水平及其升高的患者比例、血清应激指标(血清超敏C反应蛋白水平、空腹血糖和白细胞计数)和凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)]。结果干预组患者下肢深静脉血栓的发生率低于对照组患者,D-二聚体水平及其升高的患者比例均低于对照组患者,差异均有统计学意义(P﹤0.05)。术后,干预组患者的血清超敏C反应蛋白水平、空腹血糖和白细胞计数均低于对照组患者,差异均有统计学意义(P﹤0.05)。术后,干预组患者的PT、TT和APTT均长于对照组患者,差异均有统计学意义(P﹤0.05)。结论预防性干预流程联合利伐沙班可降低脊柱外科术后发生下肢深静脉血栓的风险,缓解手术应激造成的血液高凝状态,值得临床推广应用。Objective To investigate the effect of preventive intervention process combined with rivaroxaban on lower extremity deep vein thrombosis after spinal surgery.Method The clinical data of 100 patients with spinal diseases who underwent spinal surgery in Beijing Jishuitan Hospital from January 2019 to December 2021 were collected,patients were divided into intervention group(n=43)and control group(n=57)according to whether the perioperative preventive intervention process management was used.Patients in the two groups received routine management during the perioperative period,and rivaroxaban was used to prevent deep venous thrombosis of lower extremity after the surgery,while patients in the intervention group received preventive intervention process management on this basic regimen.The incidence of postoperative deep venous thrombosis,postoperative D-dimer level and its elevated proportion,serum stress indicators(serum high-sensitivity C-reactive protein level,fasting blood glucose,and white blood cell count),and coagulation function indicators[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)]were compared between the two groups.Result The incidence rate of lower extremity deep vein thrombosis in the intervention group was lower than that in the control group,and the D-dimer level and the proportion of patients with increased levels were lower than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the serum levels of high-sensitivity C-reactive protein,fasting blood glucose,and white blood cell count in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the surgery,the PT,TT,and APTT of the intervention group were longer than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The preventive intervention process combined with rivaroxaban could reduce the risk of lower extremity deep vein thrombosis after

关 键 词：预防性干预流程 利伐沙班 脊柱 手术 下肢深静脉血栓 

分 类 号：R543[医药卫生—心血管疾病]