利伐沙班与低分子肝素预防人工全膝关节置换术后深静脉血栓形成的研究

Research of rivaroxaban versus low molecular weight heparin to prevent deep venous thrombosis following total knee arthroplasty

目的探讨在防止人工全膝关节置换术后深静脉血栓的形成中应用利伐沙班的治疗价值。方法选取本院2012年1月至2013年1月骨关节外科按照随机双盲对照的原则抽取120例行人工全膝关节置换术的患者作为研究对象,平均分为观察组(60例)和对照组(60例),其中观察组患者在术后给予利伐沙班抗凝治疗,对照组患者在术后给予低分子肝素抗凝治疗,对比分析应用利伐沙班和低分子肝素治疗对患者术后血凝指标、血黏度、D-二聚体等指标的影响。结果观察组患者深静脉血栓形成的发生率与对照组相比显著降低,两组患者比较差异具有显著性(P<0.05);两组患者的血凝指标、血黏度、D-二聚体等指标治疗前后无明显变化,且术后的出血量基本相同,两组患者比较差异无显著性(P>0.05)。结论行人工全膝关节置换术的患者在术后应用利伐沙班治疗,能够显著降低深静脉血栓形成的可能性,且安全可靠,值得临床推荐应用。

Objective To observe the clinical value of rivaroxaban against deep venous thrombosis (DVT) after total knee arthroplasty (TKA). Methods 120 TKA patients from January 2012 to January 2013 were randomized into two groups:observation group with 60 cases and control group with 60 cases. Observation group was treated with rivaroxaban, and control group was treated with low molecular weight heparin after total knee arthroplasty. The effect of rivaroxaban and low molecular weight heparin on patients with coagulation indexes, blood viscosity and D-dimer were compared and analyzed. Results Compared to the control group, the occurrence rate of deep venous thrombosis in observation group was obviously lower and there was statistically signiifcant difference (P<0.05). There were no signiifcant changes in the coagulation indexes, blood viscosity and D-dimer in both groups and the amount of postoperative bleeding are basically the same. There was not signiifcant difference between the two groups (P>0.05). Conclusion The use of rivaroxaban on TKA could reduce the possibility of DVT observably and it is safe and reliable and is worthy of clinical application.