围手术期功能康复锻炼联合利伐沙班对THA术后隐性失血的影响

摘要

目的 探讨围手术期功能康复锻炼联合利伐沙班对全髋关节置换术(THA)术后隐性失血的影响.方法 将106例THA患者随机分为观察组和对照组,每组各53例.对照组术后采用利伐沙班,连续服用2周,观察组同时给予围手术期功能康复锻炼,连续1个月.比较两组患者THA术后髋关节功能恢复、隐性失血、深静脉血栓(DVT)发生情况.结果 两组术后Harris评分较术前显著提高,观察组术后3、6个月Harris评分显著高于对照组(P<0.05).观察组DVT发生率为7.5%,显著低于对照组22.6%(P<0.05).术后1个月,观察组血红蛋白、红细胞压积均与术前无明显差异(P>0.05),均明显高于对照组(P<0.05).与对照组比较,观察组术后总失血量、隐性失血量及人均输血量均明显减少,术后输血率也显著降低(P<0.05).结论 围手术期功能康复锻炼联合利伐沙班治疗THA术后患者,可有效促进关节功能恢复,降低DVT的发生,减少术后隐性失血.%Objective To explore the impact of perioperative functional rehabilitation exercise combined with rivaroxaban for hidden blood loss after total hip arthroplasty(THA).Methods 106 cases of THA patients who were treated in our hospital were randomly divided into two groups. Control group(n=53)was treated with rivaroxaban after surgery for 2 weeks,and observation group(n=53)was given perioperative functional rehabilitation exercise combined additionally for 1 months. The incidence of DVT and function rehabilitation and hidden blood loss were observed and compared.Results The score of Harris in both groups was significantly increased compared with before surgery,observation group had significant higher score than that in control group(P<0.05). The incidence of DVT after THA was in treatment group and control group 7.5% and 22.6%,it was statistically different(P<0.05). At 1 month after surgery,the level of hemoglobin,hematocrit in observation group was not significant different with before surgery,while significantly higher than that of control group(P<0.05). Compared with control group,total postoperative blood loss,hidden blood loss,amount and rate of blood transfusion in observation group were significantly reduced(P<0.05).Conclusions Perioperative functional rehabilitation exercise combined with rivaroxaban for patients after total hip arthroplasty can effectively promote joint functional recovery,reduce the occurrence of DVT,and reduce postoperative hidden blood loss.