目的 觀察利伐沙班治療老年惡性腫瘤并發(fā)下肢深靜脈血栓(DVT)的療效及安全性。方法 選取2011年12月—2014年12月在桂林醫(yī)學(xué)院附屬醫(yī)院治療的老年惡性腫瘤并發(fā)DVT患者76例, 隨機(jī)分成對(duì)照組和治療組, 每組38例。對(duì)照組sc低分子肝素鈣注射液4 250 U/次, 1次/d。治療組口服利伐沙班片, 1片/次, 1次/d。兩組均連續(xù)治療24 d。觀察兩組患者的臨床療效, 同時(shí)比較兩組治療前后下肢周徑差、血流速度的變化, 同時(shí)檢測(cè)用藥后D-二聚體、活化部分凝血活酶時(shí)間(APTT)、凝血酶原時(shí)間(PT)等指標(biāo), 評(píng)估藥物的安全性。結(jié)果 治療后, 對(duì)照組和治療組總有效率分別為86.84%、97.37%, 兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后, 兩組患者下肢周徑差顯著縮小, 同時(shí)血流速度顯著升高, 同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這兩個(gè)指標(biāo)的改善程度優(yōu)于對(duì)照組, 兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后, 兩組患者PT、APTT差異無統(tǒng)計(jì)學(xué)意義, 治療組D-二聚體顯著低于對(duì)照組, 差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組均沒有出血患者。結(jié)論 利伐沙班治療老年惡性腫瘤并發(fā)下肢深靜脈血栓療效確切, 同時(shí)具有良好的安全性, 不會(huì)增加出血的不良事件。

Objective To investigate the efficacy and safety of rivaroxaban in treatment of elderly malignant tumor complicated with lower limb deep vein thrombus. Methods Patients (78 cases) with elderly malignant tumor complicated with lower limb deep vein thrombus in Affiliated Hospital of Guilin Medical University December 2011 to December 2014 were randomly divided into control and treatment groups. Each group had 38 cases. Patients in the control group were sc administered with Low-Molecular-Weight Heparins Calcium Injection, 4 250 U/time, once daily. Patients in treatment group were po administered with Rivaroxaban Tablets, 1 tablet/time, once daily. Two groups were treated for 24 d. After treatment, the efficacy was evaluated, and the changes of lower limb diameter difference and blood flow velocity in two groups were compared. While the indexes of D-dimer, APTT, and PT in two groups were detected so as to evaluate the safety of drugs. Results The efficacies in the control and treatment groups were 86.84% and 97.37%, respectively, and there were differences between two groups (P < 0.05). After treatment, lower limb diameter difference significantly reduced, blood flow velocity significantly elevated, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P < 0.05). After treatment, there was no statistically significant difference of PT and APTT between two groups of patients. D-dimer in treatment group was significantly lower than that in the control group, with significant differences between two groups (P < 0.05). There were no hemorrhage patients in two groups. Conclusion Rivaroxaban has the good clinical effect in treatment of elderly malignant tumor complicated with lower limb deep vein thrombus, and it has good security, which will not increase bleeding adverse events.