利伐沙班等治疗脊柱融合术后下肢肌间静脉血栓的疗效观察

目的探讨利伐沙班、伊诺肝素和低分子肝素钙对脊柱融合术后下肢肌间静脉血栓的治疗效果。方法回顾性分析40例脊柱融合术后发生下肢肌间静脉血栓的患者62例肢体的临床资料,分别用利伐沙班(20例),伊诺肝素(21例)和低分子肝素钙(21例)治疗,疗程均为1~3个月,用彩超观察血栓的消失情况,观察治疗过程中的不良反应。结果治疗后,利伐沙班组和低分子肝素钙组的总有效率均高于伊诺肝素组(P<0.05);利伐沙班组和低分子肝素钙组血小板功能相关参数、内皮细胞功能相关参数与不良反应发生率均低于伊诺肝素组(P<0.05);而利伐沙班组和低分子肝素钙组之间差异均无统计学意义。结论低分子肝素钙和利伐沙班治疗脊柱融合术后急性肌间静脉血栓疗效强,安全性较高,但服药方式不同,可根据患者的需要灵活使用。

The curative effect of rivaroxaban,enoxaparin and low molecular weight heparin in the treatment of lower extremity muscular venous thrombosis after spinal fusion

Objective To investigate the effect of rivaroxaban ,enoxaparin and low molecular weight heparin calcium in the treatment of lower limb venous thrombosis after spinal fusion .Methods A retrospective analysis of 40 cases was performed with clinical da‐ta .A total of 62 cases of limb were used ,in which rivaroxaban (20 cases) ,enoxaparin (21 cases) ,and low molecular weight hep‐arin calcium (21 cases) .The treatment lasted 1‐3 months ,using color Doppler ultrasound to observe the thrombosis disappear‐ence .In the course of treatment observation of the incidence of adverse reactions .Results After the treatment ,the total effective rate of rivaroxaban and LMWH group was higher than that of enoxaparin group(P<0 .05);for rivaroxaban group and LMWH group ,the platelet function parameters ,endothelial function parameters and adverse events were lower than that of enoxaparin group(P< 0 .05);while there was no significant difference between the rivaraxaban and low molecular weight hoparin group . Conclusion LMWH calcium and rivaroxaban in the treatment of venous thrombosis after spinal fusion is effective and safe .The medication ways could be adjusted according to the patients need .