探讨利伐沙班对胃肠道恶性肿瘤并发静脉血栓栓塞症围手术期预防性抗凝的有效性和安全性  

To investigate the efficacy and safety of rivaroxaban in the treatment of gastrointestinal malignant tumor complicated with venous thromboembolism during perioperative prophylactic anticoagulation

作　　者：李杨[1] 刘烺飚 武亚东 牛磊[1] LI Yang;LIU Lang-biao;WU Ya-dong(Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院普外科,北京100050

出　　处：《临床和实验医学杂志》2023年第14期1504-1507,共4页Journal of Clinical and Experimental Medicine

基　　金：国家科技支撑计划课题(编号:2015BAI13B09)。

摘　　要：目的 探讨利伐沙班对胃肠道恶性肿瘤并发静脉血栓栓塞症(VTE)围手术期预防性抗凝的有效性和安全性。方法 回顾性收集2018年1月至2020年1月在首都医科大学附属北京友谊医院普外科住院的胃肠道恶性肿瘤并发VTE患者的临床资料,按照抗凝方法不同分组,对照组120例予常规抗凝,观察组80例予利伐沙班抗凝。采用倾向性评分匹配法(PSM),对两组间行1∶1匹配,设置卡钳值为0.2,完成匹配后两组各纳入54例。比较两组患者的抗凝时长、住院时间、住院费用、治疗总有效率、出血率、复发率、血栓、肿瘤相关病死率。结果 两组患者的抗凝时长、住院时间、住院费用、总有效率、出血率、复发率及血栓相关病死率比较,差异均无统计学意义(P>0.05)。结论 利伐沙班与低分子肝素相比,口服优势并不明显,但在胃肠道恶性肿瘤并发VTE围手术期预防性抗凝方面同样安全且有效,可以作为围手术期拒绝接受皮下注射或无法耐受皮下注射抗凝患者的替代药物。Objective To investigate the efficacy and safety of rivaroxaban in perioperative prophylactic anticoagulation in patients with gastrointestinal malignancy complicated by venous thromboembolism.Methods Clinical data of venous thromboembolism(VTE)in patients with gastrointestinal malignant tumor hospitalized in the Department of General Surgery of Beijing Friendship Hospital,Capital Medical University from January 2018 to January 2020 were retrospectively collected.Among them,according to different groups of anticoagulation methods,120 cases in the control group were given routine anticoagulation,and 80 cases in the observation group were given rivaroxaban anticoagulation.By using propensity score matching(PSM),the line between the two groups 1∶1 matching,set up the calipers value of 0.2,after complete the matching two sets of each included in 54 cases.The anticoagulation duration,hospitalization days,hospitalization cost,total effective rate and bleeding rate,recurrence rate,thrombosis,tumor related fatality rate of two groups of patients were compared.Results There were no significant differences in anticoagulant duration,length of stay and hospitalization cost,total effective rate,bleeding rate,recurrence rate,thrombosis related fatality rate between 2 groups(P>0.05).Conclusion Rivaroxaban has no obvious oral advantage compared with low molecular weight heparin,but it is also safe and effective in perioperative prophylactic anticoagulation in patients with gastrointestinal malignancy complicated by venous thromboembolism,and can be used as a substitute for patients who refuse or cannot tolerate subcutaneous anticoagulation injection during perioperative period.

关 键 词：胃肠道恶性肿瘤 静脉血栓栓塞症 预防性抗凝 利伐沙班 

分 类 号：R969[医药卫生—药理学]