The clinical application of nadroparin calcium for treating cute traumatic deep vein thrombosis in elderly patients

doi:10.3877/cma.j.issn.2096-0263.2018.02.005

Abstract

Abstract:

Objective

To analyze the clinical effect and safety of nadroparin calcium and rivaroxaban on thrombolytic therapy in elderly patients with acute deep venous thrombosis after trauma.

Methods

A prospective study was conducted on 76 patients with acute deep vein thrombosis of lower extremity fracture in the Fuzhou Second Affiliated Hospital of Xiamen University from September 2012 to December 2016. All patients were randomly divided into nodroparin calcium group and rivaroxaban group according to the computer random number method, 38 patients in each group. According to the patient's body weight, nodroparin calcium group were given thrombolytic dose by subcutaneous injection of q12 h, rivaroxaban group with rivaroxaban thrombolytic dose of q12 h orally, both treatment last for 1 week, deep venous thrombus changes and the incidence of hemorrhagic events were compared between two groups.

Results

The effective rate of thrombolysis in nodroparin calcium group was 92.105% (35/38), higher than rivaroxaban group 71.053% (27/38), difference was statistically significant (χ²=4.354, P=0.037). Both nodroparin calcium and rivaroxaban decreased the plasma levels of D-dimer (F=10050.7, P<0.001) and FIB (F=413.24, P<0.001). The level of plasma D-dimer was significantly lower than that in the rivaroxaban group (F=53.21, P<0.001). No severe bleeding was observed in both groups, and the incidence of bleeding in nodroparin calcium group was 15.789% (6/38), rivaroxaban group was 20.053% (8/38) with no statistically different.

Conclusions

For aged patients with acute deep venous thrombosis after trauma, both nodroparin calcium and rivaroxaban could be used for thrombolytic therapy with high effectiveness and better effect than rivaroxaban, while with no significant advantage on safety. Nodroparin calcium was safe and effective treatment for acute lower extremity traumatic venous thrombosis, it worth clinical promotion.

Key words: Heparin, low-molecular-weight, Rivaroxaban, Venous thrombosis

Bin Chen, Fengfei Lin, Zhaohui Lin, Ke Zheng, Ying Lin. The clinical application of nadroparin calcium for treating cute traumatic deep vein thrombosis in elderly patients[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(02): 86-91.

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References 19

1	Galanaud JP, Sevestre MA, Genty C, et al. Incidence and predictors of venous thromboembolism recurrence after a first isolated distal deep vein thrombosis [J]. J Thromb Haemost, 2014, 12(4): 436-443.
2	钱宇轩, 杨涛, 郝斌. 介入技术治疗下肢深静脉血栓的进展[J]. 血管与腔内血管外科杂志, 2016, 2(3): 241-245.
3	郭发金, 马娜, 吴明晓, 等. 超声对老年骨创伤患者下肢深静脉血栓的评价及随访[J]. 中华老年医学杂志, 2016, 35(11): 1217-1220.
4	张恒林, 谢文凯, 羊才丰, 等. 老年创伤骨折患者伤情特点及血栓形成的危险因素[J]. 中华老年多器官疾病杂志, 2017, 16(9): 677-681.
5	臧加成, 马信龙, 马剑雄, 等. 不同部位骨折深静脉血栓发生率的流行病学研究[J]. 中华骨科杂志, 2016, 36(9): 540-545.
6	Hann CL, Streiff MB. The role of vena caval filters in management of venous thromboembolism [J]. Boold Rev, 2005, 19(4): 179-202.
7	王月, 王铁铸, 吕志伟, 等. 老年髋部骨折术后下肢深静脉血栓形成的预防[J]. 中国骨与关节损伤杂志, 2013, 28(2): 137-138.
8	Chu CC, Haga H. Venous thromboembolism associated with lower limb fractures after trauma:dilemma and management [J]. J Orthop Sci, 2015, 20(2): 364-372.
9	中华医学会骨科学分会创伤骨科学组. 创伤骨科患者深静脉血栓形成筛查与治疗的专家共识[J]. 中华创伤骨科杂志, 2013, 15(12): 1013-1017.
10	Rao CN, Reddy P, Liu Y, et al. Extracellular matrix-associated serine protease inhibitors are single-gene products with differential glycosylation: cDNA cloning of the 33-kDa inhibitor revealsits identity to tissue factor pathway inhibitor-2 [J]. Arch Biochem Biophys,1996,335(1):82-92.
11	Cheng X, Zhang L, Xie NC, et al. High plasma levels of D-Dimer are independently associated with a heightened risk of deep vein thrombosis in patients with intracerebral hemorrhage [J]. Mol Neurobiol, 2016, 53(8): 5671-5678.
12	Tadeusiewicz J, Nowak P. The role of post-translational modification of fibrinogen in thepathogenesis of thrombosis [J]. Pol Merkur Lekaraki, 2015, 38(224): 107-112.
13	Garry J, Duke A, Labropoulos N. Systematic review of the complications following isolated calf deep vein thrombosis [J]. Br J Surg, 2016, 103(7): 789-796.
14	Almosni J, Meusy A, Frances P, et al. Practice variation in the management of distal deep vein thrombosis in primary vs. secondary cares: A clinical practice survey [J]. Thromb Res, 2015, 136(3): 526-530.
15	吴祥, 胡斯旺, 徐义国, 等. 应用利伐沙班预防胸腰椎骨折后路手术术后静脉血栓形成的临床观察[J]. 中国骨与关节损伤杂志, 2015, 30(5): 516-517.
16	Long A, Zhang Y. Efficacy and safety of rivaroxaban versus low-molecular weight heparin therapy in patients with lower limb fractures [J]. Thromb Thrombolysis, 2014, 38(3): 299-305.
17	Lassen MR, Haas S, Kreutz R, et al. Rivaroxaban for thromboprophylaxis after Fracture-Related orthopedic surgery in routine clinical practice [J]. Clin Appl Thromb Hemost, 2016, 22(2): 138-146.
18	Eriksson BI, Borris LC, Friedman RJ, et al. Rivaroxaban versus enoxaparin for thromboprophylaxis after hip anthroplasty [J]. N Engl J Med,2008,358: 2765-2775.
19	程志远. 彭晓新张雁伟腔静脉滤器预防肺栓塞及其并发症[J]. 中国介入影像与治疗学, 2007, 4(1): 19-21.

组别	例数	性别	年龄（岁，±s）	骨折部位（例）							血栓形成部位（例）
组别	例数	（例，男/女）	年龄（岁，±s）	髋部	股骨干	股骨踝间骨折	胫骨平台	胫腓骨	踝关节	跟骨	股髂静脉	腘静脉	胫后静脉	肌间静脉
低分子肝素钙组	38	20/18	73±4	13	3	3	4	4	6	4	7	6	16	9
利伐沙班组	38	22/16	70±9	15	4	2	4	6	4	3	6	8	13	11
统计值	?	χ²=0.213	t=1.500	?							χ²=0.167
P值	?	0.645	0.141	0.058							0.645

组别	例数	性别	年龄（岁，±s）	骨折部位（例）							血栓形成部位（例）
组别	例数	（例，男/女）	年龄（岁，±s）	髋部	股骨干	股骨踝间骨折	胫骨平台	胫腓骨	踝关节	跟骨	股髂静脉	腘静脉	胫后静脉	肌间静脉
低分子肝素钙组	38	20/18	73±4	13	3	3	4	4	6	4	7	6	16	9
利伐沙班组	38	22/16	70±9	15	4	2	4	6	4	3	6	8	13	11
统计值	?	χ²=0.213	t=1.500	?							χ²=0.167
P值	?	0.645	0.141	0.058							0.645

组别	例数	痊愈	显效	无效
低分子肝素钙组	38	22（57.9）	13（34.2）	3（7.9）
利伐沙班组	38	16（42.1）	11（28.9）	11（28.9）
χ²值	?	?	4.354	?
P值	?	?	0.037	?

组别	例数	痊愈	显效	无效
低分子肝素钙组	38	22（57.9）	13（34.2）	3（7.9）
利伐沙班组	38	16（42.1）	11（28.9）	11（28.9）
χ²值	?	?	4.354	?
P值	?	?	0.037	?

组别	例数	股髂静脉			腘静脉				胫后静脉		肌间静脉			χ²值	P值
组别	例数	通	部分通	不通	通	部分通	不通	通	部分通	不通	通	部分通	不通	χ²值	P值
低分子肝素钙组	38	7	0	0	6	0	0	12	4	0	2	4	3	17.334	0.006
利伐沙班组	38	5	0	1	7	0	1	7	3	3	2	3	6	9.097	0.028

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