| Purpose:Venous thromboembolism(VTE)is a common complication of patients with malignant tumors,and it is the first cause of death in patients with tumors besides their own tumors.Rivaroxaban is a new generation of oral anticoagulant used to treat thrombosis.It has definite efficacy and safety.It has achieved good results in the treatment and prevention of related thrombosis in orthopedic surgery and cardiology.However,there is still a lack of rivaroxa at home and abroad.A systematic clinical study on preventing thrombosis in patients with malignant tumors.This retrospective study compares rivaroxaban with the current standard preventive anticoagulant low-molecular-weight heparin calcium to explore the efficacy And safety of rivaroxaban in preventing thrombosis associated with malignant tumors,to evaluate the possibility of rivaroxaban as a new option to prevent thrombosis in patients with malignant tumors.Methods:A retrospective selection of malignant tumor patients with caprini score≥3and preventive anticoagulation who were admitted to our hospital from April2017 to December 2020 were selected.According to the admission criteria,a total of 133 cases were finally included.The use of preventive anticoagulants was divided into rivaroxaban group(67 cases)and nadroparin calcium group(66cases).Check all the imaging data(including CT,CTA,vascular color Doppler ultrasound)of the two groups of patients before,during and after treatment to determine whether there is a thrombotic event,and check the history of the two groups to understand whether there are bleeding,drug allergic reactions,liver and kidney damage during treatment,Bone marrow suppression,skin necrosis and other adverse reactions.The occurrence of thrombosis and adverse reactions between the two groups were compared.Statistical analysis was performed using Yibei statistical software,and the comparison of rates was performed byχ~2test;the comparison of two samples was performed by t test.Results:The occurrence of thrombosis in the two groups:There were 9 cases of thrombosis in the rivaroxaban group,with an incidence of 13.43%(9/67),and 6cases of thrombosis in the Nadroparin calcium group,with an incidence of9.09%(6/66).There was no significant statistical difference in the comparison(χ~2=0.626,P>0.05).There was no statistical difference between the rivaroxaban group and the nadroparin calcium group before and after treatment in various indexes of coagulation function(P>0.05).The APTT and INR in the nadroparin calcium group were increased before and after treatment(P<0.05);there was no statistical difference in the coagulation function of the rivaroxaban group before and after treatment(P>0.05).Before and after treatment,The D-dimer decline value was statistically different between the rivaroxaban group and the nadroparin calcium group(P<0.05).Logistic regression analysis of thrombosis risk showed that there was no significant difference between the rivaroxaban group and the nadroparin calcium group in the unadjusted model,adjusted model I,and adjusted model II(P>0.05).Adverse reactions:no bleeding events such as hemoptysis,subcutaneous ecchymosis,blood in the stool,bleeding gums,gastrointestinal bleeding,vaginal bleeding,etc.were observed in the rivaroxaban group and nadroparin calcium group.There were no adverse events such as allergic reactions and subcutaneous tissue necrosis.There was no statistical difference between the blood routine rivaroxaban group and the nadroparin calcium group before and after treatment(P>0.05).The contrast before and after PLT treatment in the nadroparin calcium group decreased(P<0.05),The contrast before and after HGB treatment in the rivaroxaban group decreased(P<0.05).Before treatment,the TBIL rivaroxaban group was higher than the nadroparin calcium group(P<0.05).There was no statistical difference in liver function before and after treatment in the nadroparin calcium group(P>0.05),the contrast before and after TBIL treatment in the rivaroxaban group decreased(P<0.05).There was no statistical difference in liver function between the two groups after treatment(P>0.05).There was no significant statistical significance between the rivaroxaban group and the nadroparin calcium group before and after the treatment of renal function(P>0.05).There was no statistical difference between the nadroparin calcium group and rivaroxaban group before and after renal function treatment(P<0.05).Conclusions:In medical patients with malignant tumors with caprini score≥3,There was no significant difference in the incidence of thrombosis and the incidence of adverse reactions between the rivaroxaban group using preventive anticoagulation and the nadroparin calcium group,and the efficacy and safety of the two were comparable.Rivaroxaban may be a new prophylactic anticoagulant treatment option for patients with malignant tumors with a high-risk thrombosis score. |
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