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61.
目的 评估老年骨质疏松性股骨转子间骨折病人在采用利伐沙班预防血栓的同时,联用氨甲环酸(TXA)对于减少失血的安全性和有效性.方法 纳入2017年12月至2018年12月都江堰市医疗中心老年股骨转子间骨折病人78例,所有病人均由同一治疗组医生采用股骨近端防旋髓内钉(PFNA)闭合复位内固定治疗,并接受利伐沙班的预防血栓治疗,其中41例围手术期联用TXA止血治疗(观察组),37例未使用TXA治疗(对照组).比较两组术前血红蛋白、术中显性失血量、输血及并发症情况.结果 观察组和对照组术前血红蛋白分别为(100.46±14.02)g/L及(99.30±12.48)g/L,差异无统计学意义(P>0.05).观察组和对照组的术中显性失血量分别为(101.22±25.32)mL及(179.19±21.39)mL,差异有统计学意义(P<0.01).观察组和对照组术后2 d复查血红蛋白指标分别为(73.62±14.67)g/L及(80.71±12.54)g/L,差异有统计学意义(P<0.05).观察组和对照组分别有3例及10例病人输血,输血病例比例差异有统计学意义(P=0.031).两组病人均无深静脉血栓事件发生.结论 TXA用于PFNA的围手术期治疗,可减少围手术期失血,降低输血率,联合应用利伐沙班可有效预防下肢静脉血栓形成. 相似文献
62.
63.
目的比较全髋关节置换患者注射低相对分子质量肝素(LMWH)与口服利伐沙班对深静脉血栓形成(DVT)的预防效果差异。方法选取我院2010年3月至2015年3月行全髋关节置换术患者90例,抽签随机分为两组,每组45例,一组患者注射LMWH(置LMWH组),另一组患者口服利伐沙班(利伐沙班组)。比较两组患者术后出血量、伤口引流量、血红蛋白下降水平以及不同时间段血小板计数(PLT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(a PTT)水平变化情况,比较两组患者术后DVT及不良反应发生率。结果术后出血量、伤口引流量、血红蛋白下降水平差异无统计学意义(P0.05)LMWH组患者术后DVT发生率为13.33%与利伐沙班组15.56%比较无统计学意义(P0.05);两组术后不良反应发生率无统计学意义(P0.05)。结论应用LMWH素和利伐沙班均能有效预防全髋关节置换术后静脉血栓栓塞的发生,且均具有较高的安全性。 相似文献
64.
目的:系统评价低剂量利伐沙班与达比加群在治疗非瓣膜性房颤患者中的有效性和安全性.方法:计算机检索中、英文数据库PubMed、EMBASE、Cochrane Library、MEDLINE、中国知网、万方、维普,收集低剂量利伐沙班与达比加群治疗非瓣膜性房颤有效性和安全性的队列研究,检索期限从建库至2021年8月.对符合纳入标准的研究进行资料提取和质量评价,采用Revman5.3软件进行统计学分析.结果:最终纳入了17篇研究.Meta分析结果显示:在有效性方面,利伐沙班与达比加群低剂量给药后卒中/全身性栓塞、心肌梗死发生率均无显著差异(P>0.05).在安全性方面,利伐沙班大出血、颅内出血、全因死亡风险均显著高于达比加群(P<0.05),而两组消化道出血风险无显著差异(P>0.05).亚组分析结果表明:欧洲和北美洲地区,两组卒中/全身性栓塞发生率无显著差异,利伐沙班大出血风险高于达比加群;亚洲地区,利伐沙班卒中/全身性栓塞发生率低于达比加群,但中国人群中两药无差异;两组大出血风险无显著差异.无论随访时间是否>1年,利伐沙班大出血风险均高于达比加群,且差异有统计学意义.结论:房颤患者超说明书低剂量给予达比加群的有效性与利伐沙班相似,而达比加群的安全性更高、死亡率更低;由于中国人群纳入的研究数过少,故该结论需谨慎对待. 相似文献
65.
66.
目的观察口服小剂量利伐沙班治疗不稳定型心绞痛（UA）的临床疗效。方法收集辽宁省阜新市某医院住院的UA患者165例,随机分为观察组83例及对照组82例,2组患者均给予常规双联抗血小板聚集、低分子肝素钙5～7d皮下注射抗凝、β受体阻滞剂减少心肌耗氧、血管紧张素转化酶抑制剂（ACEI）控制血压等治疗,观察组停用低分子肝素钙后,口服利伐沙班片2.5mg,每日1次。治疗8周后,比较2组患者疗效及不良反应。结果观察组显效66例,有效12例,无效5例,总有效率93.98%;对照组显效58例,有效9例,无效15例,总有效率81.71%。治疗后观察组患者平均心绞痛发作次数、心绞痛发作持续时间和心绞痛发作时心电图ST段下移较对照组均有良性改善,差异有统计学意义（P〈0.05）。观察组出血并发症较对照组无明显增加。结论口服小剂量利伐沙班治疗UA,疗效显著。 相似文献
67.
Erin R. Weeda C. Michael White W. Frank Peacock 《Current medical research and opinion》2016,32(6):1117-1120
Numerous real-world studies estimating major bleeding rates in rivaroxaban patients with nonvalvular atrial fibrillation have been published. We performed a meta-analysis to better quantify the rates of different types of major bleeding seen with rivaroxaban in observational studies. The pooled rates of major bleeding with rivaroxaban were generally low and consistent with those reported in its pivotal randomized controlled trial. 相似文献
68.
Dino Kröll Philipp C. Nett Yves Michael Borbély Sabine Schädelin Debora Bertaggia Calderara Lorenzo Alberio Guido Stirnimann 《Surgery for obesity and related diseases》2018,14(12):1890-1896
Background
Thromboembolic disease is a potentially serious complication in bariatric surgery patients. Direct oral anticoagulants (DOAC) have been investigated in orthopedic surgery patients. DOAC data after bariatric surgery are still limited to the early postsurgical period. Whether postsurgical midterm adaptations due to anatomic and physiologic alterations influence drug pharmacology is currently not known.Objective
The aim of this study was to investigate the influence of weight loss and type of bariatric surgery on midterm postsurgical pharmacokinetic and pharmacodynamic parameters of rivaroxaban.Setting
University hospital.Methods
In this monocentric study, bariatric patients received a single oral dose of rivaroxaban (10 mg) 6 to 8 months after sleeve gastrectomy (SG) or Roux-en-Y-gastric bypass (RYGB). Pharmacokinetic and pharmacodynamic parameters were assessed and compared with prebariatric surgery results.Results
We included 6 RYGB and 6 SG patients. Percent excess weight loss was 71.4% (interquartile range 56.4, 87.9) in the SG group and 76.6% (64.5, 85.7) in the RYGB group. Rivaroxaban mean areas under the curve 6 to 8 months after the bariatric procedure (922.4 µg?×?h/L, coefficient of variation 43.2) were comparable to those measured preoperatively (952.6 µg?×?h/L, 16.8). There was no relevant difference between the 2 surgical procedure groups. Rivaroxaban led to a decrease of prothrombin fragments F1+2 over 12 hours after oral intake confirming in vivo efficacy.Conclusions
Significant weight loss and altered anatomy after RYGB and SG procedures do not appear to affect the pharmacokinetics and pharmacodynamics of prophylactic rivaroxaban. A single dose of Rivaroxaban was well tolerated and considered safe in this trial. 相似文献69.
Carlos Arturo Areán Martínez Fernando Lanas Ghazi Radaideh Suleiman M. Kharabsheh Marc Lambelet Marco Antonio Lavagnino Viaud Naser Samih Ziadeh Alexander G.G. Turpie 《The Egyptian Heart Journal》2018,70(4):307-313
Background
The prospective, observational XANTUS study demonstrated low rates of stroke and major bleeding in real-world rivaroxaban-treated patients with non-valvular atrial fibrillation (NVAF) from Western Europe, Canada and Israel. XANTUS-EL is a component of the overall XANTUS programme and enrolled patients with NVAF treated with rivaroxaban from Eastern Europe, the Middle East and Africa (EEMEA) and Latin America.Methods
Patients with NVAF starting rivaroxaban for stroke prevention were consecutively recruited and followed for 1?year, at approximately 3-month intervals, or for ≥30?days after permanent rivaroxaban discontinuation. Primary outcomes were major bleeding, adverse events (AEs), serious AEs and all-cause mortality. Secondary outcomes included stroke, non-central nervous system systemic embolism (non-CNS SE), transient ischaemic attack (TIA), myocardial infarction (MI) and non-major bleeding. All major outcomes were centrally adjudicated.Results
Overall, 2064 patients were enrolled; mean age?±?standard deviation was 67.1?±?11.32?years; 49.3% were male. Co-morbidities included heart failure (30.9%), hypertension (84.2%), diabetes mellitus (26.5%), prior stroke/non-CNS SE/TIA (16.2%) and prior MI (10.7%). Mean CHADS2, CHA2DS2-VASc and HAS-BLED scores were 2.0, 3.6 and 1.6, respectively. Treatment-emergent event rates were (events/100 patient-years, [95% confidence interval]): major bleeding 0.9 (0.5–1.4); all-cause mortality 1.7 (1.2–2.4); stroke/non-CNS SE 0.7 (0.4–1.2); any AE 18.1 (16.2–20.1) and any serious AE 8.3 (7.0–9.7). One-year treatment persistence was 81.9%.Conclusions
XANTUS-EL confirmed low stroke and major bleeding rates in patients with NVAF from EEMEA and Latin America. The population was younger but with more heart failure and hypertension than XANTUS; stroke/SE rate was similar but major bleeding lower. 相似文献70.