Clinical effect of low molecular weight heparin combined with rivaroxaban in the treatment of peripheral venous catheter-associated venous thrombosis in children with leukemia
Objective To analyze the clinical effect of rivaroxaban in the treatment of peripheral venous catheter-related venous thrombosis in children with acute lymphoblastic leukemia.Methods A total of 120 children with acute lymphoblastic leukemia admitted to Henan Children's Hospital from March 2020 to March 2023 were selected and divided into the control group and the study group by the random number table meth-od,with 60 cases in each group.All children received conventional treatment and symptomatic treatment,the control group was treated with low molecular weight heparin,the study group was treated with low molecular weight heparin combined with rivaroxaban.The catheter outcome,coagulation index,vascular endothelial cell and venous patency rate,adverse events and adverse reactions were compared between the two groups after treatment.Results The rate of catheter loss(1.67％)in the study group was lower than that in the control group(11.67％),and the rate of catheter retention(95.00％)was higher than that in the control group(80.00％),with statistical significance(P＜0.05).After treatment,the levels of D-dimer and fibrinogen in the study group[(0.64±0.28)mg/L,(3.02±0.63)g/L]were lower than those in the control group[(0.78± 0.21)mg/L,(3.39±0.65)g/L].The prothrombin time and activated partial prothrombin time[(14.76± 3.61),(44.63±9.11)s]were higher than those in the control group[(12.92±3.82),(40.70±8.97)s],and the difference was statistically significant(P＜0.05).After seven days of treatment,one month after treat-ment,three months after treatment,The vWF levels of the study group[(1.34±0.28),(1.42±0.33),(1.53±0.49)μg/L]were lower than those of the control group[(1.52±0.46),(1.69±0.59),(1.85±0.62)μg/L],and the difference was statistically significant(P＜0.05).The level of vWF in two groups at three months after treatment was significantly higher than that at seven days after treatment,with statistical signifi-cance(P＜0.05).The venous patency rate of the study group(95.00％)was higher than that of the control group(83.33％)at three months after treatment,and the difference was statistically significant(P＜0.05).There was no significant difference in the incidence of adverse reactions between the study group(13.33％)and the control group(10.00％)(P＞0.05).Conclusion The combination of low molecular weight heparin in the treatment of peripheral venous catheter-related venous thrombosis in children with leukemia can improve the coagulation index,improve vascular endothelial cell function,facilitate catheter preservation,prevent bleed-ing and thrombosis recurrence,and promote the short-term prognosis.
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