首页|利伐沙班在预防肝硬化脾切除术后PVT中的应用效果

利伐沙班在预防肝硬化脾切除术后PVT中的应用效果

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目的 探讨利伐沙班在预防肝硬化脾切除术后门静脉血栓(PVT)中的应用效果.方法 将2019年2月至2021年2月接受肝硬化脾切除术的120例患者随机分为对照组与观察组,各60例.两组患者均给予腹腔镜脾切除术,对照组给予阿司匹林联合双嘧达莫治疗,观察组给予利伐沙班治疗.比较两组的治疗效果.结果 治疗后,观察组的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于对照组,D-二聚体(D-D)、血小板计数(PLT)、内皮素(ET)水平低于对照组,差异具有统计学意义(P<0.05).治疗后,观察组的门静脉直径小于对照组,最大血流速度、平均血流速度高于对照组,差异具有统计学意义(P<0.05).观察组的PVT发生率低于对照组,差异具有统计学意义(P<0.05);观察组的Yerdel分级低于对照组,差异具有统计学意义(P<0.05).两组的不良事件总发生率无明显差异(P>0.05).结论 利伐沙班可有效预防肝硬化脾切除术后患者PVT形成,安全性高,具有一定推广价值.
Application effect of rivaroxaban in the prevention of PVT after splenectomy for liver cirrhosis
Objective To explore the application effect of rivaroxaban in the prevention of portal vein thrombosis(PVT)after splenectomy for liver cirrhosis.Methods A total of 120 patients who underwent splenectomy for liver cirrhosis from February 2019 to February 2021 were randomly divided into control group and observation group,with 60 cases in each group.Both groups were given laparoscopic splenectomy,the control group was treated with aspirin combined with dipyridamole,and the observation group was treated with rivaroxaban.The therapeutic effects of the two groups were compared.Results After treatment,the activated partial thromboplastin time(APTT)and prothrombin time(PT)in the observation group were longer than those in the control group,the levels of D-dimer(D-D),platelet count(PLT)and endothelin(ET)were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the diameter of portal vein in the observation group was smaller than that in the control group,the maximum blood flow velocity and average blood flow velocity were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of PVT in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05);the Yerdel grade of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion Rivaroxaban can effectively prevent PVT formation in patients with liver cirrhosis after splenectomy,with high safety and certain promotion value.

rivaroxabanaspirindipyridamoleportal vein thrombosisliver cirrhosissplenectomy

冯永安、张锐、姚伟、刘婷、李娟

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西安医学院附属宝鸡医院普外科二病区,陕西宝鸡,721006

宝鸡市中医医院普外科,陕西宝鸡,721001

西安医学院附属宝鸡医院麻醉手术科,陕西宝鸡,721006

利伐沙班 阿司匹林 双嘧达莫 门静脉血栓 肝硬化 脾切除术

陕西省重点研发计划

2017SF-195

2024

临床医学研究与实践

临床医学研究与实践

ISSN:
年,卷(期):2024.9(12)
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