关键词: 上肢深静脉血栓, 中心静脉导管, 静脉血栓栓塞, 肝素, 低分子量, 利伐沙班

Abstract: Objective　To compare the therapeutic effects of rivaroxaban and low molecular heparin (LMWH) on malignant tumor complicated with central venous access device (CVAD) related upper extremity deep vein thrombosis (UEDVT). Methods　A total of 84 malignant tumor patients with CVAD related UEDVT in Harrsion International Peace Hospital were randomly divided into LMWH group (42 cases) and rivaroxaban group (42 cases). The catheter dysfunction rate, recurrent venous thromboembolism, D-dimer level and bleeding events were compared between the two groups in 90 days of follow-up. Results　There were no significant differences in the basic data between the two groups before treatment (all P＞0.05). There was no significant difference in the catheter dysfunction rate between the two groups (11.9% vs. 4.8%, χ2＝0.623, P＞0.05). Kaplan-Meier survival analysis suggested that there was no significant difference in the cumulative recurrence rate between the two groups (5.2% vs. 2.9%, Log-rank χ2=0.249, P＞0.05). There were no significant differences in d-dimer levels between the two groups before and after treatment at 1, 4, and 12 weeks (all P＞0.05). There was no significant difference in cumulative incidence of bleeding events between the two groups (7.1% vs. 12.1%, Log-rank χ2=0.574, P＞0.05). Conclusion　Rivaroxaban and LMWH have similar efficacy and safety in the treatment of malignant tumors with CVAD-related UEDVT. LMWH has poor compliance with subcutaneous injection, and rivaroxaban is easy to take orally, which can be used as the first choice.

Key words: upper extremity deep vein thrombosis, central venous catheters, venous thromboembolism, heparin, low-molecular-weight, rivaroxaban