利伐沙班用于人工全膝与髋关节置换术后抗凝及出血风险的比较

摘要

目的 探讨利伐沙班用于人工全膝与髋关节置换术后预防下肢深静脉血栓(DVT)形成的有效性及安全性.方法 选取2014年2月至2016年1月行单侧人工膝髋关节置换术的患者112例,采用随机数表法分为治疗组和对照组,每组56例.所有患者均按照标准骨科术式进行手术,手术完成后彻底止血.观察组于术后12 h开始口服利伐沙班,对照组于术后12 h开始皮下注射低分子肝素.比较两组术后DVT发生率以及凝血功能变化情况.结果 两组DVT发生率比较差异未见统计学意义(3.6%比1.8%,P=0.582).两组术后第2、10天凝血酶原时间(PT)及部分活化凝血酶原时间(APTT)、D-二聚体指标比较差异未见统计学意义(P>0.05).两组均未见明显不良反应.结论 利伐沙班与低分子肝素具有类似的疗效及安全性.利伐沙班应用更为便捷.%Objective To evaluate the efficacy and safety of rivaroxaban on the prevention of deep vein thrombosis(DVT) after total knee arthroplasty and total hip replacement.Methods From February 2014 to January 2016, 112 patients with unilateral knee hip replacement were selected and divided into treatment group and control group using a random number table, 56 cases in each group.All patients were operated according to the standard department of orthopedics operation, and the operation was completed.The observation group was treated with rivaroxaban 12 h after surgery, and the control group was treated with subcutaneous injection of low molecular weight heparin 12 h after surgery.The incidence of DVT and the changes of coagulation function were compared between the two groups.Results There was no significant difference in the incidence of DVT between the two groups (3.6% vs 1.8%, P=0.582).The difference of PT, APTT, D-Dimer between the two groups second days and tenth days after operation had no significant (P>0.05).No obvious adverse reactions were found in the two groups.Conclusions Rivaroxaban and low molecular weight heparin have similar efficacy and safety.Application of rivaroxaban is more convenient.