目的：比较利伐沙班与低分子肝素钙在腹部肿瘤根治术后预防深静脉血栓（DVT）形成的疗效。方法将行腹部肿瘤根治术的患者随机分成试验组48例与对照组47例。试验组于术后24 h开始服用利伐沙班10 mg口服，每天1次至术后2周，对照组患者应用低分子肝素，术后24 h开始皮下注射常规剂量0.3 mL，连续10天。术前及术后第14天检测两组活化部分凝血活酶（APTT）、凝血酶原时间（PT）、纤维蛋白原测定（Fbg）、血小板（Plt），术前及术后第1、3、7、14天抽取静脉血测定D-二聚体含量，并观察术后2天的引流量。结果试验组患者下肢DVT的发生率为4.17%（2例），对照组为2.13%（1例），两组比较差异无统计学意义（P＞0.05）。两组患者APTT、PT、Fbg、Plt、D-二聚体含量手术前后比较差异无统计学意义（P＞0.05）。结论利伐沙班与低分子肝素钙在预防腹部肿瘤根治术后深静脉血栓形成方面均有良好效果。%Objective To Compare the effect of rivaroxaban and low molecular heparin to prevent deep venous thrombosis in the abdomen after radical resection of tumor. Methods The cases of abdominal tumor resection were randomly divided into test group of 48 cases and control group of 47 cases. The test group started to take rivaroxaban 10 mg orally in 24 hours after operation, once per day for 2 weeks. The control group of patients with low molecular heparin, began to take regular doses of subcutaneous injection of 0.3 mL in 24 hours after the operation, for 10 consecutive days. The indexes of activated partial thromboplastin (APTT), prothrombin time (PT), fibrinogen (Fbg), platelet (Plt) were evaluated before operation and on the 14th day after operation. D-two dimer content of ve nous blood was measured before operation and on the 1st, 3th, 7th, and 14th day after operation. And drainage volumes 2 days after operation were observed. Results Two cases had DVT in test group patients with the occurrence rate of 4.17%. One case had DVT in control group patients with the occurrence rate of 2.13%, no statistically significant differences was found between the two groups (P>0.05). Two groups of patients with APTT, PT, Fbg, Plt, D-two dimer content had no statistically significant differences before and after operation(P>0.05). Conclusion Both rivaroxaban and low molecular heparin have satisfying anticoagulation for patients after radical resection of abdominal tumor.
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