达比加群酯与低分子肝素预防髋关节置换术后下肢深静脉血栓的作用比较

摘要

Objective To observe the clinical effects and security of low molecular weight heparin and dabigatran etexilate against deep venous thrombosis( DVT) following femoral head prosthetic replacement. Methods Totally 73 femoral head prosthetic replacement pa-tients were randomized into three groups: routine treatment group with 24 cases, dabigatran etexilate group with 25 cases and low heparin group with 24 cases. Change of platelet count and prothrombin time of the patients in three groups were observed and compared. Occurrence of DVT was observed under color Doppler of lower limbs. Results There was significant differences in DVT prevention between routine treat-ment group,the dabigatran etexilate group and low heparin group groups ( ( P <0. 05 ) . There was no intraoperative bleeding between the dabigatran etexilate group and low heparin group groups. Conclusion Dabigatran etexilatecan prevent lower extremity deep vein thrombosis after hip replacement. It has similar effects to low molecular weight heparin on DVT prevention after femoral head prosthetic replacement.%目的：比较达比加群酯与低分子肝素预防髋关节置换术后并发下肢深静脉血栓( DVT)的疗效与安全性的差异。方法选择2014年1月至2015年10月在宣城中心医院住院的单髋或双髋关节置换术患者73例，随机分为基础治疗组(对照组)24例，达比加群酯组(DE组)25例，低分子肝素组(LMWH组)24例。置换后行双下肢彩色多普勒检查评估DVT形成情况，并观察比较各组患者治疗前后血小板计数，凝血酶元时间( PT)变化情况及安全性。结果 DE组和LMWH预防DVT效果优于对照组( P<0．05)，而DE组和LMWH组患者在预防DVT发生上差异无统计学意义(P>0．05)。 DE组和LMWH组在治疗期间均无严重出血。结论达比加群酯与低分子肝素均具有较好的预防髋关节置换后DVT的发生，达比加群酯疗效及安全性与低分子肝素作用相当。