ABSTRACT
【Objective】 To evaluate the safety and efficacy of rivaroxaban in preventing portal vein system thrombosis （PVST） in patients with liver cirrhosis after splenectomy and pericardial devascularization. 【Methods】 Totally 76 cirrhotic patients underwent splenectomy and pericardial devascularization were randomly assigned to rivaroxaban treatment group （n=38） or low-molecular weight heparin （LMWH） plus warfarin treatment group （n=38）. The experimental group was given rivaroxaban 10 mg orally， once a day， for 30 days. The control group was given subcutaneous injection of 5000 IU low molecular weight heparin （LMWH） twice a day for 5 days and warfarin （initial dose 2.5 mg） orally once a day for 30 days. Both groups were followed up for 1 year. We compared the two groups in the incidence of PVST， recovery of liver function and coagulation function， decompensation of liver function， incidence of liver cancer， and active bleeding. 【Results】 Totally 18 patients （47.4%） in rivaroxaban group developed PVST， compared with 29 patients （76.3%） in LMWH plus warfarin group （P=0.024）. The incidence of PVST during the first year after operation was significantly lower in rivaroxaban group than in LMWH plus warfarin group （F=7.852， P=0.007）. The intra-group comparisons versus baseline showed that the liver function improved from POD 21 to POM 1， and coagulation function improved from POM 2 in rivaroxaban group. In contrast， the liver function improved from POM 1 to POM 2， and coagulation function improved from POM 4 in LMWH plus warfarin group. The two groups did not significantly differ in liver function decompensation， incidence of liver cancer， or active bleeding （all P>0.05）. 【Conclusion】 The prophylactic use of rivaroxaban significantly decreases the incidence of PVST after splenectomy and pericardial devascularization in cirrhotic patients compared to LMWH plus warfarin treatment. Besides， rivaroxaban treatment is safe and effective and is associated with improved liver and coagulation functions than LMWH plus warfarin treatment.
ABSTRACT
Lung cancer is the first leading cause of morbidity and mortality in the world. Venous thromboembolism (VTE) is a recognized complication in patients with lung cancer, which is one of the leading cause of death in lung cancer patients. The cancer-related, patient-related and treatment-related factors are the main causes of VTE in lung cancer patients. Malignant cells can directly activate blood coagulation by producing tissue factor (TF), cancer procoagulance (CP), inflammatory factors and cytokines; And the one of predominant mechanisms in cancer-related thrombosis is the overexpression of TF. The 10th edition of the antithrombotic therapy guidelines for VTE with cancer patients (AT-10) published in 2016 by American College of Chest Physicians (APCC) recommended that anticoagulant therapy is the basic treatment for patients with lung cancer complicated with VTE; And low molecular-weight-heparin (LMWH) is preferred as an anticoagulant drug, but can be use with caution due to increasing risk of bleeding. .
Subject(s)
Humans , Anticoagulants , Pharmacology , Therapeutic Uses , Lung Neoplasms , Risk Factors , Venous Thromboembolism , Drug TherapyABSTRACT
@#Objective To study the influence of bleeding after using low molecular weight heparin （LMWH） to prevent deep vein thrombosis (DVT) in patients with thoracolumbar spinal bursting fracture and spinal cord injury operated by rear internal fixation. Methods 120 cases were divided into the observation group (64 cases) and control group (56 cases). The observation group accepted hypodermic injection of LMWH to prevent DVT, while the control group did not. Results The volume of bleeding and blood transfusion, the change of red blood cell count (RBC) and hemoglobin were compared between two groups before and after operation. There is no statistical significance. Conclusion During the period of the operation of rear internal fixation, low molecular weight heparin cannot increase the bleeding and is safe to prevent deep vein thrombosis.
ABSTRACT
@#Objective To study the influence of bleeding after using low molecular weight heparin （LMWH） to prevent deep vein thrombosis (DVT) in patients with thoracolumbar spinal bursting fracture and spinal cord injury operated by rear internal fixation. Methods 120 cases were divided into the observation group (64 cases) and control group (56 cases). The observation group accepted hypodermic injection of LMWH to prevent DVT, while the control group did not. Results The volume of bleeding and blood transfusion, the change of red blood cell count (RBC) and hemoglobin were compared between two groups before and after operation. There is no statistical significance. Conclusion During the period of the operation of rear internal fixation, low molecular weight heparin cannot increase the bleeding and is safe to prevent deep vein thrombosis.
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Ubjective To evaluate the clinical effects of Xuesetong injecfion combined with Low-molecular-weight Heparin (LMWH) on the treatment of acute cerebral infarction (ACI).Methotis 101 cases of ACI pafiens were randomly divided into three groups:a group one with thirty-three patients were treated only with 5000 IU LMWH twice daily subcutaneously;a group two with thirty-four patients were treated with only 400 mg Xuesetong injection,one daily by intravenous drip;and a group thtee with thirty-four patients were treated with enoxaparin and Xuesetong injection.All the three groups were treated for 14 days.Impaired neurological function score,blood routine,functions of liver and kidney,blood coagulating funcfion were examined before and after the treatment.Results Significant effective rate and the effective rate of the group three were 71%and 91%respectively,higher than the other two groups(P＜0.05 or P＜0.01).No severe adverse reactions were found after the treatment.Conclusion Enoxaparin combined with Xuesetong injection is an effective regimen for the treatment of acute cerebral infarction.
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These are natural inhibitors of coagulation, and deficiencies of any of these factors is referred to as thrombophilia. The identified main causes of thrombophilia are deficiencies of antithrombin III, protein C, or protein S, resistance to actived protein C associated with Factor V Leiden mutation, and inherited hyperhomocystinemia. Inherited and acquired thrombophilias may also contribute to pathophysiological processes involved in recurrent pregnancy loss, fetal death, intrauterine growth restriction, placental abruption, placental infarction, and pre-eclampsia. Various therapeutic protocols with low-molecular-weight heparin (LMWH) were used. because it is associated with a low incidence of osteoporosis and thrombocytopenia. We experienced the two cases of successful deliveries by Cesarean section following a successful pregnancy maintenance in thrombophilia. we administered LMWH to prevent thromboembolism. one patient was the primi-gravidarum, with inherited thrombophilia, who has the familial history of pulmonary embolism and deep vein thrombosis. the other was the multi-gravidarum, with acquired thrombophilia, who has the past medical history of pulmonary embolism.
Subject(s)
Female , Humans , Pregnancy , Abruptio Placentae , Antithrombin III , Cesarean Section , Factor V , Fetal Death , Heparin, Low-Molecular-Weight , Incidence , Infarction , Osteoporosis , Pre-Eclampsia , Pregnancy Maintenance , Protein C , Protein S , Pulmonary Embolism , Thrombocytopenia , Thromboembolism , Thrombophilia , Venous ThrombosisABSTRACT
Objective:To investigate whether LMWH can protect the function of umbilical cells in hypoxia and hypoxia-reoxygenation conditions.Methods:Human umbilical vein endothelial cells,—ECV304,were planted into 6-well dishes,then cultivated respectively in three conditions:normal,hypoxia and hypoxia-reoxygenation conditions.Cells were grown for 1 hour in hypoxia condition;reoxygenated for 6 or 24 hours after 1 hour hypoxia,respectively.Cells in hypoxia and hypoxia-reoxygenation conditions were divided into two subgroups:LMWH group (5IU/ml) and control group.At each end of incubation time the medium was removed from each well.NO and MDA were measured by chromatometry.ET were measured by radioimmunoassay.Results:There was a decrease in the biosythesis and release of NO,while an increase of MDA and ET in hypoxia and hypoxia-reoxygenation conditions.The effect in hypoxia-reoxygenation condition was more remarkable than in hypoxia condition.But in both conditions LMWH could inhibit the productions of MDA and ET,increase the productions of NO.Conclusion:In hypoxia and hypoxia-reoxygenation conditions,LMWH can inhibit the production of MDA,and protect endothelial cells from oxygen free radicals.