不同时间点利伐沙班预防髋关节置换术后深静脉血栓形成的疗效研究

Efficacy of using Rivaroxaban at different time for prevention of deep venous thrombosis after hip replacement

目的比较在围手术期不同时间点使用利伐沙班预防髋关节置换术后下肢深静脉血栓(DVT)形成的效果和安全性。方法选取2014年1月-2016年10月在该院行髋关节置换手术患者150例。根据患者入选标准随机分成4组,A组术前72 h使用利伐沙班,B组术前48 h使用利伐沙班,C组术前24 h使用利伐沙班,D组术后6 h使用利伐沙班。观察4组患者在围手术期的深静脉血栓发生率、出血并发症与记录围手术期出血量。结果 A组发生DVT 1例(2.5%),B组发生DVT 4例(11.1%),C组发生DVT 5例(13.2%),D组发生DVT 11例(30.6%)。A组DVT发生率与B、C、D组比较,差异有统计学意义(P<0.05),A组低于B、C、D组。围手术期出血量上4组间比较差异无统计学意义(P>0.05)。结论术前72 h使用利伐沙班预防髋关节置换术后发生DVT的效果好,安全性高。

Objective To compare the effect and safety of using Rivaroxaban to prevent deep venous thrombosis （DVT） at different time in the perioperative stage. Methods There were 150 hip replacement patients in our hospital from January 2014 to October 2016. Based on the admission criteria, they were randomly divided into 4 groups. The patients in the group A used Rivaroxaban 72 h before operation. The patients in the group B used Rivaroxaban 48 h prior to the surgery. The patients in the group C used Rivaroxaban 24 h in advance to the operation. The patients in the group D used Rivaroxaban 6 h before operation. The incidence of DVT and hemorrhagic complications in the 4 groups of patients were observed. The perioperative bleeding volume was also recorded. Results In the groups A, there was 1 case of DVT, and the incidence was 2.5%. In the group B, 4 cases had DVT, the incidence was 11.1%. In the group C, 5 cases had DVT, the incidence was 13.2%. In the group D, 11 cases had DVT, the incidence was 30.6%. The DVT incidence of the group A was obviously lower than those in the groups B, C and D, and the differences were statistically signifcant （P 〈 0.05）. The amount of hemorrhage in the perioperative stage among the 4 groups had no statistical meaning （P 〉 0.05）. Conclusions Using Rivaroxaban 72 h before operation has better effect and higher safety in the prevention of DVT after hip replacement.