利伐沙班预防老年髋关节置换术后下肢静脉血栓的临床疗效及安全性研究

Efficacy and safety of rivaroxaban in the prevention of deep vein thrombosis in patients with hip arthroplasty

目的评价利伐沙班预防老年髋关节置换术后下肢静脉血栓的临床疗效及安全性。方法收治行单侧髋关节置换术的老年患者98例,随机分为利伐沙班组(46例)和低分子肝素组(52例),分别于术后6 h口服利伐沙班10mg·d-1,连续5周;皮下注射低分子肝素4100 U,连续2周。观察2组患者术后6个月下肢静脉血栓发生风险。结果术后随访6个月,利伐沙班组和低分子肝素分别有2,4例失访脱落。利伐沙班组与低分子肝素组下肢静脉血栓发生率分别为2.3%(1/44)和14.6%(7/48),利伐沙班组显著低于低分子肝素组(P<0.05);但2组患者术后血小板计数、凝血功能、引流量及皮下瘀斑面积差别无统计学意义(P>0.05)。结论利伐沙班可有效降低老年髋关节置换术后下肢静脉血栓发生风险,且无明显不良反应。

Objective To investigate the efficacy and safety of rivaroxaban in the prevention of deep vein thrombosis in patients with hip arthroplasty. Methods Ninety- eight patients with hip arthroplasty were recruited in our hospital. The included 98 cases were randomized divided into rivaroxaban group（ n = 46） with rivaroxaban 10 mg·d^- 1orally with5- week and low molecular heparin（ LMH） group with LMH 4100 U with2- week. The risk of deep vein thrombosis between the two groups was recorded within the flowing 6 months. Results With a follow- up period of 6 months,the incidence of deep vein thrombosis were 2. 3%（ 1/44） and 14.6%（ 7/58） in the rivaroxaban group and LMH group respectively,which indicated the incidence was much lower in rivaroxaban group（ P〈0. 05）. But the platelet count,coagulation function,drainage volume and subcutaneous ecchymosis were not different between the two groups（ P〉0. 05）. Conclusion Rivaroxaban can significant decrease the risk of deep vein thrombosis in patients with hip arthroplasty without increasing the side effects.