全髋关节置换患者注射低相对分子质量肝素与口服利伐沙班对深静脉血栓形成的预防效果比较

摘要

Objective To compare the effects between injection of low molecular weight heparin ( LMWH ) and oral administration of rivaroxiban in preventing deep venous thrombosisin ( DVT ) patients undergoing total hip replacement .Methods Ninety patients who underwent total hip replacement in our hospital between March 2010 and March 2015 were randomized into two groups ,45 cases in each group .A group of patients treated with injection of LMWH were enrolled in the LMWH group , and the other group of patients treated with oral administration of rivaroxiban were enrolled in the rivaroxiban group .The postoperative bleeding volume ,wound drainage volume ,decreased level of hemoglobin and changes of platelet count(PLT),prothrombin time(PT)and activated partial thromboplastin time (aPTT)in different time periods were compared between the two groups .The incidence rates of DVT and adverse reactions were also compared between the two groups .Results There were no significant differences in postoperative bleeding volume , wound drainage volume and the decreased level of hemoglobin ( P>0.05);there was no significant difference in the incidence of DVT between the low molecular heparin group ( 13.33%) and rivaroxaban group (15.56%)after operation(P>0.05)and the difference in the incidence of adverse reactions between the two groups was not significant ( P>0.05 ) .Conclusion The application of LMWH or rivaroxaban can effectively prevent the occurrence of venous thromboembolism after total hip replacement .Both of them are highly safe .%目的 比较全髋关节置换患者注射低相对分子质量肝素(LMWH)与口服利伐沙班对深静脉血栓形成(DVT)的预防效果差异.方法 选取我院2010年3月至2015年3月行全髋关节置换术患者90例,抽签随机分为两组,每组45例,一组患者注射LMWH(置LMWH组),另一组患者口服利伐沙班(利伐沙班组).比较两组患者术后出血量、伤口引流量、血红蛋白下降水平以及不同时间段血小板计数(PLT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)水平变化情况,比较两组患者术后DVT及不良反应发生率.结果 术后出血量、伤口引流量、血红蛋白下降水平差异无统计学意义(P>0.05)LMWH组患者术后DVT发生率为13.33%与利伐沙班组15.56%比较无统计学意义(P>0.05);两组术后不良反应发生率无统计学意义(P>0.05).结论 应用LMWH素和利伐沙班均能有效预防全髋关节置换术后静脉血栓栓塞的发生,且均具有较高的安全性.