老年全髋关节置换术后患者阿哌沙班预防下肢深静脉血栓形成的效果观察

Effect of Apixaban on Prevention of Deep Venous Thrombosis of Lower Extremity in Elderly Patients After Total Hip Replacement

目的观察阿哌沙班预防老年全髋关节置换术后患者下肢深静脉血栓形成的效果。方法选择2019年3月-2021年3月在蚌埠医学院第一附属医院接受人工全髋关节置换术的老年患者120例,随机分为观察组和对照组各60例,在患肢关节肌肉主动功能性锻炼的同时,对照组患者采用皮下注射低分子肝素,观察组患者予以口服阿哌沙班片,比较患者术前及术后凝血指标及下肢深静脉血栓发生率。结果两组患者术前血小板(Plt)、部分凝血活酶时间(APTT)、凝血酶原时间(PT)及D-二聚体(D-dimer)水平的比较无统计学差异(P>0.05);术后7d两组患者Plt、APTT及PT比较,差异无统计学意义(P>0.05),而观察组患者D-dimer水平显著低于对照组患者(P<0.05)。随访显示观察组患者下肢深静脉血栓发生率为5.00%,显著低于对照组患者(16.67%),差异具有统计学意义(P<0.05)。结论阿哌沙班在老年全髋置换术后患者中预防深静脉血栓形成较低分子肝素效果更优。

Objective To observe the effect of Apixaban on prevention of deep venous thrombosis of lower extremity in elderly patients after total hip replacement.Methods A total of 120 elderly patients who received total hip arthroplasty in our hospital from March 2019 to March 2021 were randomLy divided into observation group and control group.The control group received subcutaneous injection of low molecular weight heparin while the observation group received oral apixaban tablets.The preoperative and postoperative coagulation indexes and the incidence of deep venous thrombosis of lower limbs were compared.Results There were no significant differences in preoperative levels of Plt,APTT,PT and D-dimer between two groups(P>0.05).There were no significant differences in Plt,APTT and PT between two groups 7 days after surgery(P>0.05),while the D-dimer level in observation group was significantly lower than that in control group(P<0.05).Follow-up showed that the incidence of lower limb deep vein thrombosis in the observation group was 5.00%,which was significantly lower than that in the control group(16.67%),and the difference was statistically significant(P<0.05).Conclusion Apixaban is more effective than low molecular weight heparin in preventing deep vein thrombosis in elderly patients after total hip replacement.