利伐沙班联合达肝素钠预防骨折术后下肢深静脉血栓的价值  

Value of rivaroxaban combined with heparin sodium in preventing lower extremity deep vein thrombosis after fracture surgery

作　　者：申玲 柳继 Shen Ling;Liu Ji(Department of Drug and Equipment,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,China;Department of Joint I,Nanyang Hospital of Traditional Chinese Medicine,Nanyang 473000,China)

机构地区：[1]南阳市中医院药械科,南阳473000 [2]南阳市中医院关节一科,南阳473000

出　　处：《中国实用医刊》2024年第24期70-73,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究利伐沙班联合达肝素钠用于预防骨折术后下肢深静脉血栓(DVT)的价值。方法队列研究。抽取2023年4月至2024年4月于南阳市中医院行手术治疗的骨折患者62例, 根据随机数字表法分为单一组和联合组, 每组31例。单一组采用达肝素钠治疗, 联合组采用利伐沙班联合达肝素钠治疗。比较两组下肢DVT发生率、凝血功能[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)]、炎症反应指标[C反应蛋白(CRP)、血小板计数(PLT)]及不良反应发生率。结果联合组下肢DVT发生率(6.45%, 2/31)低于单一组(45.16%, 14/31), P<0.05。治疗后, 联合组APTT、PT水平高于单一组, 且D-D水平低于单一组(P<0.05)。治疗后, 联合组CRP、PLT水平低于单一组(P<0.05)。联合组不良反应发生率(12.90%, 4/31)与单一组(6.45%, 2/31)比较差异未见统计学意义(P>0.05)。结论骨折术后患者采用利伐沙班与达肝素钠联合治疗, 能有效预防下肢DVT的发生, 改善凝血功能, 降低炎症反应指标, 且不会增加不良反应发生率。Objective To investigate the value of rivaroxaban combined with heparin sodium in preventing deep vein thrombosis(DVT)of lower extremity after fracture surgery.MethodsSixty-two patients with fractures who underwent surgical treatment in Nanyang Hospital of Traditional Chinese Medicine from April 2023 to April 2024 were selected for the cohort study.And they were divided into the single group and the combined group according to the random number table method,with 31 cases in each group.The single group was treated with heparin sodium,and the combined group was treated with rivaroxaban combined with heparin sodium.The incidence of DVT,coagulation function assessed by prothrombin time(PT),activated partial thromboplastin time(APTT)and D-dimer(D-D),levels of inflammatory response indexes including C-reactive protein(CRP)and platelet count(PLT),and incidence of adverse reactions were compared between the two groups.ResultsThe incidence of DVT in the combined group(6.45%,2/31)was lower than that in the single group(45.16%,14/31),P<0.05.Compared with the single group,the combined group had higher levels of APTT and PT,and had lower D-D level after treatment(P<0.05).After treatment,the levels of CRP and PLT in combined group were lower than those in the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the combined group(12.90%,4/31)and the single group(6.45%,2/31),P>0.05.ConclusionsRivaroxaban combined with heparin sodium can effectively prevent the development of lower limb DVT,improve coagulation function,reduce inflammatory response indicators,and do not increase the incidence of adverse reactions in patients after fracture surgery.

关 键 词：达肝素钠 利伐沙班 下肢深静脉血栓 

分 类 号：R47[医药卫生—护理学]