利伐沙班与间歇充气加压对髋关节置换术后深静脉血栓的预防作用

摘要

Objective To explore the preventive effect of rivaroxaban combined with intermittent pneumatic compression in patients after hip replacement.Methods 84 cases with hip arthroplasty were randomly divided into control group and experiment group.The control group of 42 cases(47 hips)were given low molecular weight heparin combined with intermittent pneumatic compression.The experiment group of 42 cases(48 hips)were given rivaroxaban combined with intermittent pneumatic compression.Coagulation indicator and hemorheology were compared before treatment,1 weeks after treatment and 2 weeks after treatment,and patients were detected by lower extremity ultrasound detection,prevention of thrombosis and bleeding recorded during treatment status.Results APTT and TT of the experiment group were lower than the control group after 2 weeks of treatment with statistical significance(P<0.05);The deep venous thrombosis of experiment group was 2 cases(4.76%)and the control group was 6 cases(14.29%),with no statistical significance.Two groups of patients with perioperative bleeding after drainage was not statistically significant.Conclusion Compared with low molecular heparin,rivaroxaban combine with intermittent pneumatic compression has a lower extremity deep venous thrombosis prevention after hip replacement surgery,without increasing the risk of bleeding.%目的：探讨利伐沙班与间歇充气加压（ intermittent pneumatic compression，IPC）装置对髋关节置换术（ hip replacement）后深静脉血栓的预防作用。方法选取湖州市中心医院行髋关节置换术患者84例，按随机数字表法分为对照组和研究组，对照组42例（47髋）术后予以低分子肝素钙联合间歇充气加压装置治疗；研究组42例（48髋）术后予以利伐沙班联合间歇充气加压装置治疗，分别于治疗前、治疗1周及治疗2w时测定凝血指标及血液流变学指标，同时行双下肢彩色超声检测，记录治疗期间血栓预防及出血状况。结果研究组治疗1 w时D-二聚体、2 w时APTT、TT显著低于对照组（ P＜0.05）；研究组下肢深静脉血栓2例（4.76％）与对照组下肢深静脉血栓6例（14.29％）比较，无统计学意义（P＞0.05）；2组患者围术期出血量、术后引流量无统计学意义。结论相对于低分子肝素钙，利伐沙班联合间歇充气加压装置能有效预防髋关节置换术后下肢深静脉血栓，且不增加出血风险。