Challenging anticoagulation therapy for multiple primary malignant tumors combined with thrombosis: A case report and review of literature

Table 1 The changes of indexes before and after operation were examined

Date	May 30, 2023, 13:00	May 30, 2023, 23:53	May 31, 2023	Operation	June 1, 2023	June 2, 2023	June 3, 2023	June 5, 2023	June 6, 2023	…	October 27, 2023
D-dimer (mg/L)	80.55	64.91	53.64	Operation	30.89	19.55	13.67	9.02	8.67	…	3.00
Fibrinogen quantification (g/L)	1.86	1.76	2.08	Operation	2.14	1.87	1.92	1.79	1.96	…	2.57

A notable reduction in the patient's postoperative D-dimer level was observed in comparison to the preoperative period.

Table 2 Anticoagulation regimens in different situations

	Mode of administration	Initial therapeutic dose	Maintenance of therapeutic dose	Extended treatment dose
Unfractionated heparin	Intravenous	Maintain APTT 1.5 times the upper limit of normal	/	/
Low molecular heparin	Subcutaneous	200 IU/kg/d for 1 month	150 IU/kg	/
Rivaroxaban	Oral	15 mg each time, twice a day for 3 wk	20 mg each time, once a day	20 mg each time, once a day
Apixaban	Oral	10 mg each time, twice a day for 1 wk	5 mg each time, twice a day	2.5 mg each time Twice a day
Eldosaban	Oral	At least 5 d of heparin introduction is required, with dose reduction after LMWH introduction, i.e. 30 mg each time, once a day	60 mg each time, once a day	60 mg each time, once a day

LMWH: Low molecular weight heparin; APTT: Activated partial thromboplastin time.