The Study Of VTE Prophylaxis Following Elective Posterior Spine Surgery

OBJECTIVE:Venous thromboembolism(VTE), which includes deep venous thrombosis(DVT) and pulmonary embolism(PE), is a serious and potentially fatal surgical complication. The goal of our study was to examine characteristics, incidence, the efficacy and safety of VTE prophylaxis with Rivaroxaban after elective posterior spine surgery.METHODS:We identified120adult patients who underwent elective posterior spine surgery from the First Affiliated Hospital of Guangxi Medical University between August2011and December2011. There were78males and42females, the average age was58.1years (range,19-82years). All the patients Were randomly divided into experimental group(60cases) or control group(60cases). All procedures were performed under general anesthesia and prone position. Experimental groups:the first postoperative day start receiving Rivaroxaban (Xarelto(?)) anticoagulation therapy; control group:neither mechanical methods nor anticoagulation medications were used for prophylaxis against thromboembolism. Duplex ultrasound (DUS) was performed before and7days after surgery. Hemoglobin, platelets, blood clotting, D-dimer, alanine aminotransferase (ALT) and blood loss were recorded. Observe whether thromboembolic clinical symptoms appear and any surgical complications. All cases followed up for30days after discharge.RESULTS:A total of115cases of effective cases, the control group of58cases and the experimental group of57cases. The prevalence in the control group was13.8%(8/58), including1cases of symptomatic,7cases of asymptomatic, PE occurred in1patient then died, the rate was1.7%(1/58). In the experimental group the incidence of DVT was1.8(1/57), no PE and death; the incidence of DVT shows statistically significant between two groups (P<0.05). Fibrinogen, D-dimer, ALT in7days after surgery, and prothrombin time in3days after surgery, were significantly different (P<0.05or P<0.01) between the groups.1cases of hypodermic gore and1case of melena were found in the experimental group, none in the control group, but the risk of bleeding was no significant difference. Wound healing or infection were not discovered in any groups.CONCLUTIONS:Patients undergoing elective posterior spine surgery face DVT risk, it is efficacy and safety for these patients use Rivaroxaban to prevent thromboembolism.