摘要
目的观察利伐沙班治疗肿瘤相关血栓(CAT)的临床效果及安全性。方法回顾性选取2021年11月—2023年11月盐城市第一人民医院收治的肿瘤合并CAT患者69例,按照治疗方法不同分为利伐沙班组35例与低分子肝素组34例。低分子肝素组给予低分子量肝素钠注射液,利伐沙班组给予利伐沙班片,2组均治疗2周。比较2组临床疗效,治疗前与治疗2周后下肢深静脉血栓患者患侧与健康侧周径差、凝血酶原时间(PT)与D-二聚体(D-D)水平,不良反应及随访4周复发率。结果利伐沙班组治疗总有效率高于低分子肝素组(97.14%vs.76.47%,χ^(2)=4.803,P=0.028)。治疗2周后,2组患肢周径差均减小,且利伐沙班组小于低分子肝素组(P<0.05或P<0.01);2组PT治疗前后及治疗后组间比较,差异无统计学意义(P>0.05);2组D-D水平降低,且利伐沙班组低于低分子肝素组(P<0.01)。利伐沙班组不良反应总发生率与低分子肝素组比较,差异无统计学意义(11.43%vs.11.76%,χ^(2)=0.111,P=0.740)。随访4周,利伐沙班组与低分子肝素组复发率比较,差异无统计学意义(11.54%vs.8.82%,χ^(2)=0.008,P=0.931)。结论利伐沙班在治疗CAT方面,较低分子肝素钠注射液抗凝效果显著,减轻患者血栓情况,且具有方便快捷、安全性高等优势。
Objective To observe the efficacy and safety of rivaroxaban in the treatment of CAT.Methods A total of 69 patients with cancer complicated with CAT admitted to the Yancheng No.1 People′s Hospital from November 2021 to November 2023 were retrospectively enrolled,and they were divided into the rivaroxaban group(35 cases)and the low m olecular weight heparin group(34 cases)according to the treatment method.The low molecular weight heparin group was given low-molecular-weight heparin sodium injection,and the rivaroxaban group was given rivaroxaban tablets,and both groups were treated for 2 weeks.The clinical efficacy,the difference in limb circumference between the affected and healthy sides in patients with lower extremity deep vein thrombosis,changes in PT and D-D levels before treatment and after 2 weeks of treatment,as well as adverse reactions and the recurrence rate at 4-week follow-up between the two groups were compared.Re sults The total effective rate of rivaroxaban group was higher than that of the low molecular weight heparin group(97.14%vs.76.47%,χ^(2)=4.803,P=0.028).After 2 weeks of treatment,the difference in limb circumference between the affected and healthy sides decreased in patients with lower extremity deep vein thrombosis in both groups,and this difference was s ignificantly smaller in the rivaroxaban group compared to the low molecular weight heparin group(P<0.05 or P<0.01).There was no statistically significant difference in PT between the two groups before and after treatment and between the two groups after treatment(P>0.05).The D-D levels of the two groups were decreased,and the rivaroxaban group was lower than that of the low molecular weight heparin group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the rivaroxaban group and the low molecular weight heparin group(11.43%vs.11.76%,χ^(2)=0.111,P=0.740).At 4 weeks of follow-up,there was no significant difference in the recurrence rate between the the rivaroxaban group and the low molecular weight heparin group(11.54%vs.8.82%,χ^(2)=0.008,P=0.931).Conclusion Rivaroxaban has a significant anticoagulant effect in the treatment of CAT,with lower molecular weight heparin sodium injection,which can r educe the thrombosis of patients,and has the advantages of convenience,rapidity and high safety.
作者
衣素琴
严文跃
高见书
刘红旗
朱成振
马旭
YI Suqin;YAN Wenyue;GAO Jianshu;LIU Hongqi;ZHU Chengzhen;MA Xu(Department of Oncology,Yancheng First Hospital Affiliated of Nanjing University Medical College/Yancheng No.1 People′s Hospital,Jiangsu Province,Yancheng 224001,China;不详)
出处
《临床合理用药》
2025年第15期11-13,21,共4页
Chinese Journal of Clinical Rational Drug Use
基金
江苏省卫生健康委科研课题(Z2018044)。
关键词
肿瘤相关血栓
静脉血栓栓塞
利伐沙班
低分子肝素钠注射液
凝血指标
安全性
Cancer-associated thrombosis
Venous thromboembolism
Rivaroxaban
Low molecular weight heparin sodium injection
Coagulation indicators
Safety
