利伐沙班预防膝关节置换术后下肢深静脉血栓形成的疗效观察

The prevention and treatment of the rivaroxaban for deep vein thrombosis of lower extremity after knee arthroplasty

[目的]探讨利伐沙班预防膝关节置换术后下肢深静脉血栓形成的疗效.[方法]选取行全膝关节置换的90例,随机分为利伐沙班组及低分子肝素组,每组各为45例,观察下肢深静脉血栓发生率、引流量、D-二聚体数值变化、肺动脉栓塞及严重出血事件、手术前后血小板计数(PLT)及活化部分凝血活酶时间(APTT)变化.[结果]利伐沙班组及低分子肝素组中发生下肢深静脉血栓者分别为2例(4.4%),5例(11.1%);两组切口引流量、PLT,APTT及不良事件间差异均无统计学意义(P>0.05);两组术后1,3,7,14dD-二聚体数值间差异均具有统计学意义(P<0.05),利伐沙班组优于低分子肝素组.[结论]利伐沙班预防膝关节置换术后深静脉血栓形成疗效良好,且具有很较的安全性.

OBJECTIVE To investigate the prevention and treatment of the rivaroxaban for deep vein thrombosis（DVT） of lower extremity after knee arthroplasty. METHODS 90 patients with total knee arthroplasty were selected and randomly divided into rivaroxaban and low molecular heparin （LMWH） groups, 45 cases in each group. It was observed that the incidence of DVT, incision bleeding, D-dimer change in value, pulmonary embolism, serious bleeding events, before and after surgery platelet （PLT） counts and activated partial thromboplastin time（APTT） change in value. RESULTS There were 2 patients （4.4%）with DVT in rivaroxaban group, and 5 patients （11.1%） with DVT in LMWH group, and the incision bleeding, PLT, APTT and adverse events had no significant differences between two groups （P〉 0.05）, and The D-dimer change in value in 1 d, 3 d, 7 d and 14 d of postoperation were significant differences between two groups （P〈0.05）, and it was indicated that the rivaroxaban group was better than LMWH group. CONCLUSION The rivaroxaban has good curative effect and security for preventing the DVT after knee arthroplasty.