利伐沙班预防髋关节周围骨折术后深静脉血栓形成50例

摘要

目的 探讨利伐沙班预防髋关节周围骨折术后深静脉血栓形成的疗效.方法 选择2009年5月至2011年5月在医院行髋关节周围骨折手术的患者100例,随机均分成利伐沙班组和低分子肝素组各50例.于髋关节周围骨折术后6 h内,低分子肝素组给予低分子肝素钠40 mg/d皮下注射,持续用药2周;利伐沙班组给予利伐沙班片10 mg/d口服,持续用药1周.于治疗第1周、第2周后采用彩色多普勒超声检查两组患者深静脉血栓的形成情况.结果 低分子肝素组发生深静脉血栓8例(16.00%),利伐沙班组发生深静脉血栓2例(4.00%),两组深静脉血栓发生率比较有显著性差异(P<0.05).利伐沙班组无明显不良反应发生.结论 利伐沙班能有效预防髋关节周围骨折术后深静脉血栓形成,具有良好的安全性,值得临床推广.%Objective To investigate the clinical efficacy of rivaroxaban on preventing deep vein thrombosis (DVT) in postoperative bone fractures around hip joint. Methods A hundred patients with hip joint peripheral bone fracture treated by operation in our hospital from May 2009 to May 2011 were selected and randomly divided into two groups, rivaroxaban and low molecular weight heparin (LMWH) groups, 50 cases in each group. The rivaroxaban group was given oral rivaroxaban 10 mg at postoperative 6 h, once a day for continuous 1 week. The LMWH group was given LMWH 40 mg/d within postoperative 6 h, by subcutaneous injection for continuous 1 week. The DVT formation was detected by color Doppler ultrasound and compared between two groups after 1 - and 2 - week treatment. Results Eight case had DVT in the LMWH group with the occurrence rate of 16% and 2 cases had DVT in the rivaroxaban group with the occurrence rate of 4%, showing statistical difference between the two groups (P<0. 05). The rivaroxaban group had no obvious adverse reactions. Conclusion Rivaroxaban can effectively prevent postoperative DVT in hip joint peripheral bone fracture and has good security with less adverse reactions, which can be used in clinical practice.