利伐沙班在预防导管相关性血栓中的作用  

Role of Rivaroxaban in the Prevention of Catheter Related Thrombosis

作　　者：王君艳[1] 白栓成[1] WANG Junyan;BAI Shuancheng(Baotou Central Hospital,Baotou 014040,China;不详)

机构地区：[1]包头市中心医院,内蒙古包头014040

出　　处：《中外医学研究》2024年第20期123-127,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2022年度内蒙古自治区卫生健康科技计划项目(202201505)。

摘　　要：目的:对比利伐沙班和低分子肝素对重症监护室(ICU)患者导管相关性血栓(CRT)预防的影响。方法:选取2019年6月—2021年9月包头市中心医院ICU收治的120例符合中心静脉置管入组标准的患者作为研究对象,按随机数表法分为利伐沙班组、低分子肝素组和空白对照组,各40例。三组行深静脉穿刺置管后均给予深静脉导管常规护理,分别给予利伐沙班,低分子肝素及不抗凝处理。比较三组CRT发生率、不同时点的凝血指标[血浆纤维蛋白原(FIB)、D-二聚体(D-D)]及抗凝药物相关性出血的发生情况。结果:空白对照组CRT发生率显著高于利伐沙班组、低分子肝素组,差异有统计学意义(P<0.05),利伐沙班组和低分子肝素组CRT发生率比较,差异无统计学意义(P>0.05)。T_(2)、T_(3)和T_(4)时,利伐沙班组、低分子肝素组FIB、D-D低于T_(1)时,T_(3)和T_(4)时,利伐沙班组、低分子肝素组FIB、D-D低于T_(2)时,T_(4)时,利伐沙班组、低分子肝素组FIB、D-D低于T_(3)时,差异有统计学意义(P<0.05);T_(2)、T_(3)和T_(4)时,利伐沙班组FIB、D-D低于低分子肝素组及空白对照组,且低分子肝素组低于空白对照组,差异有统计学意义(P<0.05)。三组不同时间点FIB及D-D比较,差异有统计学意义(P<0.001);三组间FIB及D-D比较,差异有统计学意义(P<0.001);组间和时间存在交互作用(P<0.001)。低分子肝素组相关性出血总发生率高于利伐沙班组,差异有统计学意义(P<0.05)。结论:在ICU患者CRT的预防中,利伐沙班与低分子肝素均有效,但利伐沙班对凝血功能的改善效果更佳,安全性更高。Objective:Effect of Rivaroxaban and Low Molecular Weight Heparin on prevention of catheter related thrombosis(CRT)in intensive care unit(ICU)patients.Method:A total of 120 patients in the ICU of Baotou Central Hospital from June 2019 to September 2021 who met the admission criteria for central venous catheterization were selected as the study objects,and divided into Rivaroxaban group,Low Molecular Weight Heparin group and blank control group according to the random number table method,with 40 cases in each group.After deep venous puncture catheterization,all three groups were given routine care with deep venous catheterization,they were give Rivaroxaban,Low Molecular Weight Heparin and non-anticoagulant treatment,respectively.The incidence of CRT,coagulation indexes[plasma fibrinogen(FIB),D-dimer(D-D)]at different time points and the occurrence of anticoagulant drug-related bleeding were compared among the three groups.Result:The incidence of CRT in blank control group was significantly higher than that in Rivaroxaban group and Low Molecular Weight Heparin group,the differences were statistically significant(P<0.05),but there was no statistical significance in the incidence of CRT between Rivaroxaban group and Low Molecular Weight Heparin group(P>0.05).At T_(2),T_(3) and T_(4),FIB and D-D in Rivaroxaban group and Low Molecular Weight Heparin group were lower than that at T_(1);at T_(3) and T_(4),FIB and D-D in Rivaroxaban group and Low Molecular Weight Heparin group were lower than that at T_(2);at T_(4),FIB and D-D in Rivaroxaban group and Low Molecular Weight Heparin group were lower than that T_(3),and the differences were statistically significant(P<0.05).At T_(2),T_(3) and T_(4),FIB and D-D in Rivaroxaban group were lower than those in Low Molecular Weight Heparin group and blank control group,and which in Low Molecular Weight Heparin group was lower than those in blank control group,the differences were statistically significant(P<0.05).The difference of FIB and D-D among the three groups at different time

关 键 词：导管相关性血栓 利伐沙班 重症监护室 血浆纤维蛋白原 D- 二聚体 

分 类 号：R472[医药卫生—护理学]