The Relatively Study About The Safety Of The Application Of The Anticoagulant Substances After The Operative Of Spinal Coumn Which Is In Order To Prevent The DVT

Objective To investigate the characteristic and risk of the DVT after the spine surgery and the validity and safety of the application of the Rivaroxaban to anticoagulation and prevent the DVT.Date And Method the date is from the120adult patients who accept the spine surgery in the afflicated hospital of the medicial college Qingdao University from2012.11to2013.10.Among them,there are76male and44female and the average age is57.1years old(the least is20years old and the oldest is81years old) The patients were tandomly divided into experment group and control group and each group has64patients.The patients from control group did not take any medicine or mechanical means to prevent the DVT after the operation. The patients from the experiment group take the Rivaroxaban from the moment after the operation,10mg for a time,and until a week after discontinuation of the drug activity. All the patients do not have any disease of the blood circulation.And they have the normal blood coaglation mechanism and do not have the history of cerebral thrombosis,cerebral infarction and other thromboembolic disease.they do not take any anticoagulation drugs through intravenous injection and oral intake. The anesthesia is the general anesthesia.All the patients take the Blood test of the Prothrombintime,Hemoglobin,the two D-dimer,Platelet,and the liver fuction(ALT and AST) before and after the operation. Observating if there are the symptom of the Thromboembolism.Take the color dopple ultersound examination of lower limbs in before the operation and seven days after the operation. Obseving if there are the sympton of the venous thrombosis and we also should observe the operation incision and the operation complications.Following up one month after the patient has leaving the hospital.Result there are117effective cases in both experimental group and control group. Among them,the control group has58patients and the experimental group has59patients,.There are7patients who come from the control group has the DVT after the operation one by one.,Among them, one patient has the PE and dead.The incidence and the mortality is1.7%(1/58).there are6patients who have the symptom The incidence is10.4%(6/58) There is only one patient who has the DVT in the experimental group. The incidence of the DVT is1.7%(1/59),And there is no patient who has the PE or death. In comparison of the two groups, the incidence of the DVT has the statistically significant.(P<0.05).The patients in the two groups take the test of Plasma fibrinogen,the Plasma D-dimer,Platelet,the Prothrombin time in the NO1,4,7days afer the operation. And the test about liver fuction(ALT and AST) in one week after the operation.Make the statistical analysis between the two group’s result. There are2patients who have the bleeding,1patient has the black stool,1patient has operation incision subcutaneous congestion in the experimental group.The symptoms have been ease after stopping the drugs,and they did not get the DVT until they leaving the hospital.The rest patients from the experimental and control groups do not have the symptoms of Subcutaneous congestion,Epidural hematoma, Black stool,Gingival bleeding,and so on.In the risk of bleeding,the two groups have no the ststistically significant.(P>0.05) The patients are both follwed up one month after the surgery.And they are covered very well.there is no case which is readmission caused by the bleeding disease.Conclusion In the premise of no creasing the risk of bleeding,the patient who take the spine surgery should take the Rivaroxaban at the early of postoperation to anticoagulantn can decrease the risk of the DVT and will not increase the risk of bleeding,espcially the patient who rest in bed for a long time.