本文選題：利伐沙班　切入點(diǎn)：華法林　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：下肢深靜脈血栓形成(Lower extremity deep venous thrombosis LEDVT),是血液在下肢深靜脈血管內(nèi)發(fā)生異常凝集形成血栓。首選治療是抗凝治療,預(yù)防血栓繼續(xù)進(jìn)展,降低血栓脫落風(fēng)險(xiǎn)。華法林作為經(jīng)典的抗凝藥物,抗凝效果好,但需要定期監(jiān)測(cè)凝血酶指標(biāo)。其出血風(fēng)險(xiǎn)及服用不方便導(dǎo)致了部分患者不能獲益。而新型口服抗凝藥利伐沙班(Rivaroxaban)是直接針對(duì)凝血因子X(jué)a的一種抑制劑,減少凝血酶原復(fù)合物中的Xa因子而起到抗凝作用。不需要監(jiān)測(cè)凝血,出血幾率低,服用方便。目前的說(shuō)明書(shū)主要針對(duì)歐美深靜脈血栓人群,本實(shí)驗(yàn)通過(guò)觀察患者臨床療效、患肢周徑、凝血指標(biāo)的變化、治療后血栓及血管再通狀況的變化,探索山東半島急性下肢深靜脈血栓形成人群服用利伐沙班的有效劑量。方法:將煙臺(tái)毓璜頂醫(yī)院、山東省千佛山醫(yī)院、濰坊市人民醫(yī)院、威海市立醫(yī)院、臨沂市第二人民醫(yī)院等多家中心2015-12至2016-12符合納入標(biāo)準(zhǔn)的急性下肢深靜脈血栓患者共308例。隨機(jī)分成A組(10mg組)和B組(15mg組)。A組患者入院后給予利伐沙班10mg p.o bid。B組患者入院后給予利伐沙班15mg p.o bid。兩組其他治療相同。通過(guò)觀察患者臨床療效、患肢周徑、凝血指標(biāo)的變化,同時(shí)觀察兩組患者有無(wú)不良反應(yīng)及并發(fā)癥。結(jié)果:本研究證明A組患者與B組患者進(jìn)過(guò)治療后均明顯好轉(zhuǎn),肢體周徑差2cm,凝血指標(biāo)差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論:對(duì)于膠東半島急性下肢深靜脈血栓形成的患者可給予利伐沙班10mg p.o bid來(lái)進(jìn)行抗凝治療,既安全有效又減輕經(jīng)濟(jì)負(fù)擔(dān)。
[Abstract]:Lower extremity deep venous thrombosis LEVT is an abnormal coagulation of blood in the deep vein of lower extremity. The first choice is anticoagulant therapy to prevent thrombus progression. Reduce the risk of thrombus loss. Warfarin, as a classic anticoagulant, has a good anticoagulant effect. But there is a need for regular monitoring of thrombin markers. The risk of bleeding and inconvenient use of thrombin may not benefit some patients. Rivaroxaban, a new oral anticoagulant, is a direct inhibitor of the coagulation factor Xa. Reducing the Xa factor in prothrombin complex plays an anticoagulant effect. There is no need to monitor coagulation, the bleeding probability is low, and it is convenient to take it. The present instructions are mainly aimed at the people with deep venous thrombosis in Europe and the United States. In this experiment, we observed the clinical efficacy of the patients. The changes of peripheral diameter of affected limbs, blood coagulation index, thrombus and vascular recanalization after treatment were studied in order to explore the effective dosage of rivastaban in acute lower extremity deep vein thrombosis in Shandong Peninsula. Shandong Qianfoshan Hospital, Weifang people's Hospital, Weihai Municipal Hospital, A total of 308 patients with acute deep venous thrombosis of lower extremity met the inclusion criteria from 2015-12 to 2016-12 in Linyi second people's Hospital and other centers. They were randomly divided into two groups: group A (10 mg) and group B (15 mg). After admission, the patient was given Rivashaban 15 mg p.o bid. the other two groups were treated the same. By observing the clinical efficacy of the patients, The changes of peripheral diameter and coagulation index of the affected limbs, and the adverse reactions and complications of the two groups were observed. Results: this study proved that the patients in group A and group B were obviously improved after treatment. Conclusion: patients with acute lower extremity deep vein thrombosis in Jiaodong Peninsula can be treated with 10 mg bid of Levashaban for anticoagulant therapy, which is safe, effective and economical.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R543.6

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