阿司匹林与依诺肝素钠对全膝关节置换术后静脉血栓塞症的预防作用

Preventive Effect of Aspirin and Enoxaparin Sodium on Venous Thromboembolism after Total Knee Arthroplasty

目的:探讨阿司匹林与依诺肝素钠对全膝关节置换术后静脉血栓塞症的预防作用,为临床选用合适的抗凝药物预防静脉血栓塞症提供一定的理论参考依据。方法:选择2015年3月-2016年11月于本院行全膝关节置换术患者120例,根据使用药物的不同将其分为阿司匹林组(n=51)与依诺肝素钠组(n=69)。观察比较两组治疗后下肢深静脉血栓形成、肺栓塞、出血并发症、术后引流量及血红蛋白下降的情况。结果:两组栓塞发生率、下肢深静脉血栓发生率、术后引流量及血红蛋白下降情况比较,差异均无统计学意义(P>0.05);阿司匹林组出血事件发生率比依诺肝素钠组高,差异有统计学意义(P<0.05)。结论:依诺肝素钠预防全膝关节置换术后静脉血栓的形成具有良好的有效性及安全性,且不会增加患者出血风险;阿司匹林具有良好的临床效果,但可能会增加患者出血风险,其安全性需进一步研究。

Objective： To investigate the preventive effect of Aspirin and Enoxaparin Sodium on venous thrombosis after total knee arthroplasty, and to provide some theoretical reference for the clinical selection of anticoagulant drugs to prevent venous thrombosis.Method： A total of 120 cases of total knee arthroplasty were selected from March 2015 to November 2016 in our hospital as the research objects, according to the use of drugs, they were divided into Aspirin group （n=51 ） and Enoxaparin Sodium group （ n=69 ） .Lower limb deep venous thrombosis, pulmonary embolism, bleeding complications, postoperative drainage volume and hemoglobin of two groups were observed and compared.Result： There were no significant differences in the in.cidence of emboiization, the incidence of deep venous thrombosis, postoperative drainage and hemoglobin descending of two groups （P〉0.05 ） ; the incidence of bleeding of the Aspirin group was higher than that in Enoxaparin Sodium group, the difference was statistically significant （ P〈0.05 ） .Conclusion： Enoxaparin Sodium has a good efficacy and safety in preventing the formation of venous thrombosis after total knee arthroplasty, and does not increase the risk of bleeding; Aspirin has a gored clinical effect, but it may increase the risk of bleeding, and its security needs further study.