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目的探讨利伐沙班预防老年结直肠癌患者术后下肢深静脉血栓形成(DVT)的效果。方法回顾性收集2007年11月至2013年10月期间黄石市第二医院收治的256例老年结直肠癌手术患者的临床资料,根据是否应用利伐沙班预防下肢DVT将患者分为利伐沙班组136例和对照组120例,比较2组患者的术后出血情况、术后1~3 d的腹腔引流量、D-二聚体阳性率、术后3 d及术后7 d的凝血酶原时间(PT)及部分活化凝血酶原时间(APTT),以及下肢DVT的发生情况。结果 2组患者的出血事件发生率〔8.1%(11/136)比4.2%(5/120)〕和D-二聚体阳性率〔71.3%(97/136)比75.8%(91/120)〕比较差异均无统计学意义(P>0.05);术后3 d和术后7 d,2组患者的PT〔(12.5±0.8)s比(12.8±0.5)s、(12.2±0.5)s比(12.0±0.7)s〕和APTT〔(31.9±1.5)s比(32.2±4.6)s、(33.6±2.4)s比(34.6±2.8)s〕比较差异也均无统计学意义(P>0.05)。术后发生下肢DVT 46例,其中利伐沙班组9例(6.6%),对照组37例(30.8%),对照组的下肢DVT发生率较高(P=0.00)。结论利伐沙班可以安全、有效地预防老年结直肠癌患者术后下肢DVT的发生。
Objective To investigate the effect of rivaroxaban in preventing postoperative deep vein thrombosis (DVT) in elderly patients with colorectal cancer. Methods The clinical data of 256 elderly patients with colorectal cancer who underwent surgery in the Second Hospital of Huangshi from November 2007 to October 2013 were retrospectively collected. Patients were divided into rivaroxaban 136 cases in control group and 120 cases in control group. The postoperative bleeding, the drainage of abdominal cavity 1 ~ 3 days after operation, the positive rate of D-dimer, the thrombin Original time (PT) and partial activation of prothrombin time (APTT), as well as lower extremity DVT. Results The incidence of hemorrhage (8.1% (11/136) vs. 4.2% (5/120)) and D-dimer positive rate (71.3% (97/136) vs 75.8% (91/120) (12.5 ± 0.8) s (12.8 ± 0.5) s and (12.2 ± 0.5) s respectively in the two groups at 3 days and 7 days after operation (P> 0.05) (12.0 ± 0.7) s] and APTT (31.9 ± 1.5 s vs 32.2 ± 4.6 s, 33.6 ± 2.4 s vs 34.6 ± 2.8 s) (P> 0.05). There were 46 cases of lower extremity DVT after operation, including 9 cases (6.6%) in rivaroxaban group and 37 (30.8%) cases in control group. The incidence of DVT in lower extremity in control group was higher (P = 0.00). Conclusion Rivaroxaban can safely and effectively prevent postoperative DVT in elderly patients with colorectal cancer.