低分子肝素与利伐沙班预防老年患者骨折置换术后双下肢深静脉血栓的有效性和安全性比较

摘要

目的:比较低分子肝素、利伐沙班预防老年患者骨折置换术后双下肢深静脉血栓(DVT)的有效性和安全性.方法:58例行髋关节或人工股骨头置换术的老年患者随机分为低分子肝素组(29例)和利伐沙班组(29例).所有患者术后均给予基本治疗及物理预防DVT;在此基础上,利伐沙班组患者术后10 h开始口服利伐沙班片10 mg,每日1次,连用10 d;低分子肝素组患者术后10 h给予低分子肝素钙注射液4100 IU,皮下注射,每日1次,连用10 d.观察两组患者术后DVT发生情况,D-二聚体阳性发生情况,凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及血小板计数异常发生情况.结果:两组患者DVT发生率,术后4、10 d两组患者D-二聚体阳性发生情况,PT、APTT、TT、FIB及血小板计数异常发生情况比较,差异均无统计学意义(P>0.05).结论:低分子肝素、利伐沙班均可用于预防老年患者骨折置换术后双下肢DVT,且其疗效和安全性均相当.%OBJECTIVE:To compare the effectiveness and safety of low-molecular-weight-heparin(LMWH)calcium and rivar-oxaban in preventing lower extremity deep venous thrombosis (DVT) in the elderly patients after surgery of replacement of frac-ture. METHODS:A total of 58 elderly patients underwent hip or artificial femoral head replacement were randomly divided into LMWH group (29 cases) and Rivaroxaban group (29 cases). All patients received basic prevention and physical prevention for DVT after surgery. Based on this,LMWH group was given Heparin calcium injection 4100 IU subcutaneously 10 h after surgery, for 10 d. Rivaroxabar group was given Rivaroxaban tablet 10 mg 10 h after surgery,once a day,for consecutive 10 d. The occur-rence of DVT and positive D-dimer were observed in 2 groups after surgery. The PT,APTT,TT,FIB and platelet counts abnormal-ity were also observed in 2 groups. RESULTS:There was no statistical significance in the incidence of DVT,the occarrence of pos-itive D-dimer,PT,APTT,TT,FIB and platelet counts abnormality 4,10 d after surgery between 2 groups(P>0.05). CONCLU-SIONS:LMWH and rivaroxaban both can be used for lower extremity DVT in the elderly patients after replacement of fracture sur-gery of and have similar therapeutic efficacy and safety.