利伐沙班预防全髋关节置换术后深静脉血栓形成的临床观察

Clinical Observation of Preventing Deep Venous Thrombosis with Rivaroxaban after Total Hip Arthroplasty

目的：探讨利伐沙班预防全髋关节置换术后深静脉血栓形成的疗效与安全性。方法：将60例行人工全髋关节置换术的患者随机分为治疗组与对照组,每组30例。术后第1～35天,治疗组给予利伐沙班每次10 mg,每日1次,口服;对照组给予低分子肝素100 U,每日1次,皮下注射。观察两组患者术前及术后3 d凝血五项及术后3个月深静脉血栓形成情况,比较两组患者术中出血量、术后引流量及输血量。结果：治疗后,两组凝血五项同时间点比较,差异均无统计学意义（P〉0.05）。治疗组术后引流量明显少于对照组,两组比较,差异有统计学意义（P〈0.05）。两组术中出血量及总输血量比较,差异无统计学意义（P〉0.05）。结论：利伐沙班具有抗凝、溶栓作用,可以降低人工全髋关节置换术后深静脉血栓的发生率,减少手术出血量、术后引流量,安全性好,值得在临床上推广。

Objective：To investigate the efficacy and safety of Rivaroxaban in the prevention of deep venous thrombosis （ DVT ） after total hip arthroplasty.Methods：60 patients to undergo artificial total hip replacement were randomly divided into a treatment group and a control group,30 cases in each group.From the first to the 35th day after operation,the treatment group was orally given 10 mg of Rivaroxaban,once daily, and the control group was given subcutaneous injection of low molecular weight heparin （ LMWH,4100 U ） ,once a day, observing five items of coagulation of the two groups before and after operation and the formation of DVT after 3 months and comparing bleeding volume during operation,postoperative drainage volume and blood transfusion volume of the two groups.Results：After treatment,the differences between five items of coagulation at the same time point were not statistically significant （P 〉 0.05 ） .The postoperative drainage volume of the treatment group was significantly less than that in the control group,and the difference was statistically significant （ P 〈 0.05 ） .There was no significant difference between the bleeding volume during operation and the total blood transfusion volume of the two groups （ P 〉 0.05 ） .Conelusion：Rivaroxaban,with the effect of anticoagulation and thrombolysis,can reduce the incidence .of DVT after total hip replacement and the amount of bleeding and postoperative drainage,safe and worthy of promotion in clinical practice.