预防性抗凝对大隐静脉射频闭合术后症状性静脉血栓栓塞的影响  

Effect of prophylactic anticoagulation on symptomatic venous thromboembolism after radiofrequency closure of the great saphenous vein

作　　者：翁超[1] 杨光唯[1] 虞聪[1] 蒋劲松[1] WENG Chao;YANG Guangwei;YU Cong;JIANG Jinsong(Department of Vascular Surgery,Zhejiang Provincial People's Hospital(Hangzhou Medical College Affiliated People's Hospital),Hangzhou 310014,China;不详)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)血管外科,杭州310014

出　　处：《浙江医学》2024年第12期1305-1308,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2023KY542)。

摘　　要：目的探讨大隐静脉射频闭合术后使用预防性抗凝药物对症状性静脉血栓栓塞(VTE)的影响。方法回顾性选取2022年1至12月在浙江省人民医院血管外科行大隐静脉射频闭合术的1074例患者为研究对象,其中未接受口服预防性抗凝药物组(未接受抗凝治疗组)106例、接受利伐沙班10 mg抗凝治疗5 d组(预防性抗凝5 d组)762例、接受利伐沙班10 mg抗凝治疗10 d组(预防性抗凝10 d组)206例。比较3组患者术后1个月内VTE发生率和出血性事件发生率。结果未接受抗凝治疗组术后1个月内未发生VTE,预防性抗凝5 d组和预防性抗凝10 d组术后1个月内VTE发生率分别为0.52%(4/762)和0.49%(1/206),3组患者术后1个月内VTE发生率比较差异无统计学意义(P=0.593)。未接受抗凝治疗组和预防性抗凝5 d组术后1个月内未发生出血性事件;预防性抗凝10 d组术后出现血尿1例,发生率为0.49%(1/206),3组患者术后1个月内出血性事件发生率比较差异无统计学意义(P=0.191)。结论大隐静脉射频闭合术后预防性抗凝使用利伐沙班未能明显降低VTE发生率,但也不会增加出血风险。Objective To investigate the effect of prophylactic anticoagulants on symptomatic venous thromboembolism(VTE)after radiofrequency closure of the great saphenous vein.Methods A total of 1074 patients who underwent radiofrequency closure of the great saphenous vein in the Department of Vascular Surgery of Zhejiang Provincial People's Hospital from January 2022 to December 2022 were retrospectively selected as the study objects.Among them,106 patients did not receive prophylactic anticoagulant therapy(no-anticoagulantion group),762 patients received 10 mg rivaroxaban for 5 d(5-d anticoagulation group),and 206 patients received 10 mg rivaroxaban for 10 d(10-d anticoagulation group).The incidence of VTE and hemorrhagic events within 1 month after surgery were compared among the 3 groups.Results No VTE occured within 1 month after surgery in the no-anticoagulantion group,while the incidence of VTE within 1 month after surgery in the 5-d and 10-d anticoagulantion group was 0.52%(4/762)and 0.49%(1/206).There was no statistically significant difference in the incidence of VTE within 1 month after surgery among the 3 groups(P=0.593).No hemorrhagic events occured within 1 month after surgery in the no-anticoagulantion group and the 5-d anticoagulantion group.One case of hematuria occured in the 10-d anticoagulantion,with an incidence of 0.49%(1/206).There was no statistically significant difference in the incidence of hemorrhagic events with 1 month after surgery among the 3 groups(P=0.191).Conclusion Prophylactic anticoagulantion with rivaroxaban after radiofrequency closure of the great saphenous vein may not significantly reduce the incidence of VTE,but it may not increase the risk of hemorrhage.

关 键 词：大隐静脉曲张 大隐静脉射频闭合术 利伐沙班 静脉血栓栓塞 

分 类 号：R654.4[医药卫生—外科学]