Prevention Deep Vein Thrombosis After Spinal Cord Injury Related Reasearch

[OBJECTIVEO]To investigate the efficacy and safety of rivaroxaban prevention of spinal cord injury of deep vein thromosis.[METHODS]A prospective clinical trial was carried out in80consecutive patients with SCI who will have anterior, posterior or Anteior and posterior joint s decompr-ession surgery. The patient’s admission time from March2011to February2012. Patients were randomly divided into two groups according to the date of admiss-ion. A group of patients taking rivaroxaban, a group of patients was the control group. To compare the incidence of deep vein thrombosis and pulmonary embolism.[RESULTS]A total of80cases was included, rivaroxaban38cases,42cases of blank control group. The Rivaroxaban group in the proportion of males was73.7%,64.3%of cervical spinal cord injury, the proportion of cases who needed to switch to rehabilitation department for further treatment was42.1%; the proportion of males accounted for69.0%of the blank control group; the proportion of patients for cervical spinal cord injury was52.6%; the proportion of patients who need to transfer to the rehabilitation department for further treatment was52.4%; In the rivaroxaban group, The incidence of DVT was 2.7%, There was no pulmonary embolism events and deaths; In the blank control group, the rate of deep vein thrombosis was28.3%;the rate of pulmonary embolism was14.29%and all patients had cervical spinal cord injury; the rate of fatal pulmonary embolism was2.4%; Two patients found to have proximal thrombosis,10patients with distal embolization; There are three patients with symptomatic thrombosis, nine patients with asymptomatic thrombosis.;10cases of DVT and5cases of PE occurred in the rehabilitation; The rate of deep venous thrombosis and pulmonary embolism in the groups have statistically significant difference (p<0.05). In the diagnosis of DVT, D-dimer negative predictive value100%, positive predictive value is11.5%. Visible D-dimer can be used as a detection method to exclude deep vein thrombosis; the fourth day after D-dimer values, after removal of the drainage tube on the two groups no statistically significant difference,also in the number of PT and APTT; to cutting postoperative drainage of the sand team more traffic than the control group, but no statistically significant difference (P>0.05); In the rivaroxaban grouo,there was2cases of delayed wound healing; One patient because of gastrointestinal bleeding cause the stool black; liver alanine transaminase elevation more than the normal twice3cases; In the blank control group, delayed wound healing one cases. No major bleeding events in both groups, cardiovascular events and kidney damage. The two groups the risk of bleeding was no significant difference.[CONCLUSION]Rivaroxaban can significantly reduce the incidence of postoperative deep vein thrombosis and pulmonary embolism of spinal cord injury; Rivaroxaban does not increase the risk of postoperative bleeding, wound infection and of liver function impairment.