全膝关节置换术患者隐性失血抗凝药物的临床应用

The effect of anticoagulant drugs on hidden blood loss in patients with total knee arthroplasty

目的探讨抗凝药物应用对人工全膝关节置换术患者隐性失血的影响。方法选取2010年4月～2014年5月期间在我院接受人工全膝关节置换术的患者180例,随机分为A组84例和B组96例,分别于术后使用不同的抗凝药物。其中A组于术后10小时口服抗凝药物利伐沙班,B组于术后10小时皮下注射抗凝药物依诺肝素钠。统计评估所有患者的一般临床资料,比较两组患者的术后引流量、术后出血量、术后隐性出血量、住院时间,并进行术后两周的膝关节评分（HSS）。结果两组患者的一般资料比较差异无统计学意义（P〉0.05）,两组术后引流量、术后出血量以及术后隐性出血量的差异不具有统计学意义（P=0.531、0.594、0.442）;且两组患者平均住院时间以及HSS得分差异也不明显,差异不具有统计学意义（P=0.897、0.806）。结论抗凝药物依诺肝素钠以及利伐沙班对全膝关节置换术患者术后隐性失血及术后患者膝关节恢复情况的影响差异不明显,均可在临床应用。

Objective To research the effect of anticoagulant drugs on hidden blood loss in patients with total knee arthroplasty. Methods 180 patients with total knee arthroplasty were were randomly assigned into A group and B group. Rivaroxaban was carried out on patients in A group. The enoxapari was carried in B group. The general clinical information, postoperative drainage of fluid, blood loss, hidden blood loss, hospital stay time and American hospital for special surgery knee score （HSS） 2 weeks after operation were compared between the two groups. Results From the ex- perimental results, the differences of the general information between two groups patients did not show significant differ- ence （P〈0.05）. The difference of postoperative drainage of fluid, blood loss, hidden blood loss between two groups was not significant （P=0. 531, 0. 594, 0. 442）. The difference of average hospital stay length and HSS score between two groups was not obvious, no statistically significant was showed （P=0. 897, 0. 806）. Conclusion The difference of effect of anticoagulant drugs rivaroxaban and enoxapari to hidden blood loss and postoperative recovery in patients with total knee arthroplasty is not significant.