CAJ | 학술논문

目的：观察比较利伐沙班与依诺肝素预防腰椎术后下肢深静脉血栓( DVT)的效果。方法选取我院100例择期腰椎手术的DVT高危患者,随机分为利伐沙班组( A组,50例)和依诺肝素组( B组,50例)。分别于术后6h和12h开始口服利伐沙班和注射依诺肝素；均于患者能下床活动后停药。分别于术前和术后7d检测血D-二聚体,记录凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)。术后记录48 h引流量,术后7 d行双下肢血管超声检查。结果两组患者均无明显的下肢DVT形成和肺栓塞发生。 A组术后48 h的引流量,术后7 d肌肉静脉血栓发生率及D-二聚体、PT、APTT的水平较B组差异均无统计学意义( P>0．05),且均无切口周围血肿、消化道出血、硬膜外血肿等不良反应发生。结论利伐沙班预防腰椎术后下肢DVT形成的效果与依诺肝素相当,且安全有效。
목적：관찰비교리벌사반여의낙간소예방요추술후하지심정맥혈전( DVT)적효과。방법선취아원100례택기요추수술적DVT고위환자,수궤분위리벌사반조( A조,50례)화의낙간소조( B조,50례)。분별우술후6h화12h개시구복리벌사반화주사의낙간소；균우환자능하상활동후정약。분별우술전화술후7d검측혈D-이취체,기록응혈매원시간(PT)화활화부분응혈활매시간(APTT)。술후기록48 h인류량,술후7 d행쌍하지혈관초성검사。결과량조환자균무명현적하지DVT형성화폐전새발생。 A조술후48 h적인류량,술후7 d기육정맥혈전발생솔급D-이취체、PT、APTT적수평교B조차이균무통계학의의( P>0．05),차균무절구주위혈종、소화도출혈、경막외혈종등불량반응발생。결론리벌사반예방요추술후하지DVT형성적효과여의낙간소상당,차안전유효。
Objective To observe the effects of rivaroxaban and enoxaparin on preventing deep venous throm-bosis( DVT) after lumbar surgery. Methods 100 high-risk cases with DVT undergoing elective lumbar spine surgery in our hospital were selected and randomly divided into rivaroxaban group(group A,n=50)and enoxaparin group(group B,n=50). Patients in both groups were orally administrated with rivaroxaban and enoxaparin at 6 hours and 12 hours perceptively until all the patients could walk off bed. The levels of D-dimer,PT and APTT in blood were detected 7 days before and after the operation perceptively. Drainages volumes of 48 hours after the operation were recorded. Double lower extremity vascular ultrasound was performed 7 days after the operation. Results No significant forma-tions of lower extremity DVT and pulmonary embolism were noted. There was no significant difference in drainages at 48 hours,incidence of muscular veniplex thrombosis at 7 days after the operation,and the levels of D-dimer,PT and APTT between group A and group B(P>0. 05). No adverse events,such as hematoma around the incision,gastrointes-tinal bleeding,epidural hematoma were observed. Conclusion Rivaroxaban and enoxaparin have the same effects on preventing DVT after lumbar surgery and they are found to be safe and effective.