| Objective:Venous Thromboembolism(VTE)is a group of systemic diseases,including pulmonary thromboembolism(PE)and Deep Venous Thrombosis(DVT).It is a common complication of respiratory diseases,and it is also the main disease leading to unexpected death of hospitalized patients.We selected four respiratory diseases(lung cancer,chronic obstructive pulmonary disease,interstitial lung disease and senile pneumonia)prone to prethrombotic state as representatives,then we conduct a prospective,randomized controlled study,which studies inpatients with these respiratory diseases who have high risk of VTE in some medical centers.Randomly divided into two groups,fondaparinux sodium and low molecular weight heparin were used for preventive anticoagulation therapy,and the safety and effectiveness of fondaparinux sodium in preventing venous thromboembolism(VTE)in patients with respiratory diseases were analyzed and compared,in order to provide some guidance and reference for clinical work.Methods:(1)In this study,patients with respiratory diseases admitted to several medical centers from November 2020 to October 2021 were selected.According to Padua score,the patients with high risk of VTE(Padua score ≥4)were evaluated.According to the inclusion and exclusion criteria,217 cases were screened out and randomly assigned to fondaparinux group(105 cases)and low-molecular-weight-heparin(LMWH)group(112 cases).There were 78 males and27 females in fondaparinux group,aged 38-95 years,with an average age of(72.24±9.72)years.In LMWH group,there were 87 males and 25 females,aged52-91 years,with an average age of(73.46±8.40)years.(2)Two groups of patients were treated with different drugs for preventive anticoagulation: fondaparinux group was treated with fondaparinux(2.5 mg/d),and LMWH group was treated with enoxaparin sodium(4000 Axa IU/d).Observe the incidence of bleeding events and thrombosis events within 7 days and within 1 month after taking the medicine,compare the general data and laboratory examination of the two groups before and after taking the medicine,and make normal test for the measurement data,and compare the measurement data with independent samples T-test between groups,and rank sum test for the measurement data that does not meet the normal distribution.Counting data is expressed by composition ratio or probability,and chi-square test is used to compare between groups.Results:(1)Comparing the laboratory examination results before treatment with those after treatment,the red blood cell count and hemoglobin of patients in the fondaparinux group decreased after the treatment(P-value < 0.05),while the D-dimer decreased(P < 0.05)and the activated partial thromboplastin time(APTT)prolonged(P < 0.05).There was no significant difference in other laboratory examination results(P-value > 0.05).There was no significant difference in the laboratory examination results of LMWH group before and after medication(P-value > 0.05).(2)The 7-day thrombotic event rate of patients in fondaparinux group was lower than that of LMWH group(0 to 5.4%,P-value < 0.05),the 7-day bleeding event rate of fondaparinux group was not statistically different from that of LMWH group(0 to4.5%,P-value > 0.05),and the 30-day thrombotic event rate of fondaparinux group was lower than that of LMWH group.Conclusion:In the clinical VTE prophylaxis of patients at high risk of VTE with respiratory diseases: 7 days after treatment,fondaparinux sodium was more effective than low molecular weight heparin in the preventive treatment of VTE,but there was no significant difference in safety;30 days after treatment,fondaparinux sodium was more effective and safer than low molecular weight heparin in the prophylaxis of VTE.Using fondaparinux sodium to prevent venous thromboembolism in patients with respiratory diseases has obvious effectiveness and higher safety,which can be recommeded. |
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