[1]陈宾,林凤飞,林朝晖,等.低分子肝素钙治疗老年创伤后急性深静脉血栓的临床应用[J].中华老年骨科与康复电子杂志,2018,(02):86-91.[doi:10.3877/cma.j.issn.2096-0263.2018.02.005]
　Chen Bin,Lin Fengfei,Lin Zhaohui,et al.The clinical application of nadroparin calcium for treating cute traumatic deep vein thrombosis in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(02):86-91.[doi:10.3877/cma.j.issn.2096-0263.2018.02.005]
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低分子肝素钙治疗老年创伤后急性深静脉血栓的临床应用()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年02期
页码:
86-91
栏目:
深静脉血栓
出版日期:
2018-03-31

文章信息/Info

Title:
The clinical application of nadroparin calcium for treating cute traumatic deep vein thrombosis in elderly patients
作者:
陈宾1; 林凤飞1; 林朝晖1; 郑科1; 林盈2
350007 厦门大学附属福州第二医院骨科1，超声科2
Author(s):
Chen Bin1;  Lin Fengfei1;  Lin Zhaohui1;  Zheng Ke1;  Lin Ying2
1Department of Orthopaedics, 2Department of Ultrasound, the Fuzhou Second Affiliated Hospital of Xiamen University, Fuzhou 350007, China
关键词:
肝素; 低分子量;  利伐沙班;  静脉血栓形成
Keywords:
Heparin;  low-molecular-weight;  Rivaroxaban;  Venous thrombosis
DOI:
10.3877/cma.j.issn.2096-0263.2018.02.005
文献标志码:
A
摘要:
目的 分析低分子肝素钙和利伐沙班对老年创伤后急性深静脉血栓患者溶栓治疗的临床效果及安全性。方法 前瞻性收集厦门大学附属福州第二医院2012年9月至2016年12月老年下肢骨折急性深静脉血栓形成患者76例，电脑随机数字法将其分配成低分子肝素钙组和利伐沙班组，每组患者38例，根据患者体重，低分子肝素钙组予以溶栓剂量q12 h皮下注射进行溶栓治疗，利伐沙班组给予溶栓剂量q12 h口服进行溶栓治疗，连续治疗1 w，比较两组患者的深静脉血栓变化情况及出血性事件发生率。结果 低分子肝素钙组溶栓有效率为92.105%（35/38），利伐沙班组溶栓有效率为71.053%（27/38），低分子肝素钙组中溶栓有效率高于利伐沙班组，差异有统计学意义（c2=4.354，P=0.037）；低分子肝素钙和利伐沙班均可降低患者血浆D-dimer（F=10050.7，P＜0.001）及FIB水平（F=413.24，P＜0.001），低分子肝素钙组患者血浆D-dimer水平均显著低于利伐沙班组（F=53.21，P＜0.001）；两组均无严重出血事件，低分子肝素钙组出血发生率为15.789%（6/38），利伐沙班组出血发生率为20.053%（8/38），两组出血性事件发生率差异无统计学意义。结论 对于创伤后急性深静脉血栓的老年患者，低分子肝素钙和利伐沙班均可进行有效的溶栓治疗，低分子肝素钙的溶栓疗效高于利伐沙班，在安全性方面，利伐沙班并无显著优势。低分子肝素钙治疗创伤后急性下肢静脉血栓疗效肯定，安全性高，值得临床推广。
Abstract:
Objective To analyze the clinical effect and safety of nadroparin calcium and rivaroxaban on thrombolytic therapy in elderly patients with acute deep venous thrombosis after trauma. Methods A prospective study was conducted on 76 patients with acute deep vein thrombosis of lower extremity fracture in the Fuzhou Second Affiliated Hospital of Xiamen University from September 2012 to December 2016. All patients were randomly divided into nodroparin calcium group and rivaroxaban group according to the computer random number method, 38 patients in each group. According to the patient’s body weight, nodroparin calcium group were given thrombolytic dose by subcutaneous injection of q12 h, rivaroxaban group with rivaroxaban thrombolytic dose of q12 h orally, both treatment last for 1 week, deep venous thrombus changes and the incidence of hemorrhagic events were compared between two groups. Results The effective rate of thrombolysis in nodroparin calcium group was 92.105% (35/38), higher than rivaroxaban group 71.053% (27/38), difference was statistically significant (c2=4.354, P=0.037). Both nodroparin calcium and rivaroxaban decreased the plasma levels of D-dimer (F=10050.7, P<0.001) and FIB (F=413.24, P<0.001). The level of plasma D-dimer was significantly lower than that in the rivaroxaban group (F=53.21, P<0.001). No severe bleeding was observed in both groups, and the incidence of bleeding in nodroparin calcium group was 15.789% (6/38), rivaroxaban group was 20.053% (8/38) with no statistically different. Conclusions For aged patients with acute deep venous thrombosis after trauma, both nodroparin calcium and rivaroxaban could be used for thrombolytic therapy with high effectiveness and better effect than rivaroxaban, while with no significant advantage on safety. Nodroparin calcium was safe and effective treatment for acute lower extremity traumatic venous thrombosis, it worth clinical promotion.

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备注/Memo

备注/Memo:
基金项目：福建省自然科学基金面上项目（2016j01598）
更新日期/Last Update: 2018-03-27