利伐沙班与低分子肝素在老年粗隆间骨折术后预防下肢深静脉血栓的依从性调查

The compliance of rivaroxaban and low molecular weight heparin in the prevention of deep vein thrombosis of lower extremity after intertrochanteric fracture of the elderly

目的通过调查利伐沙班与低分子肝素在老年粗隆间骨折患者术后预防下肢深静脉血栓临床应用中,两种药物在使用方法、疗效、不良反应等方面的比较,评价患者对两种药物的执行依从性。方法通过调查问卷、住院期间对病人的观察记录以及出院后电话回访等,对160例老年粗隆间骨折术后患者的两种药物使用情况进行统计分析,观察比较两者的有效性、安全性和依从性。结果通过调查问卷得出160例患者中有34例不接受利伐沙班,97例患者不接受低分子肝素,两组的依从性比较具有统计学意义(P<0.001)。120例使用利伐沙班患者中有13例发生了恶心、呕吐等不良反应,而40例使用低分子肝素的患者中有27例发生了硬结、紫瘢等不良反应,两组比较具有统计学意义(P<0.05)。通过对患者住院病例分析及观察记录,两种药物使用患者在有效性和安全性方面,两组比较无统计学意义(P>0.05)。结论利伐沙班作为口服抗凝药物,服用方便,副作用小,患者服药依从性高;而在有效性和安全性方面,利伐沙班与低分子肝素的抗凝作用相当,可作为骨科患者术后预防下肢深静脉血栓的常规治疗措施。

Objective：To compare rivaroxaban and low molecular weight heparin in terms of methods,efficacy and adverse reactions,and evaluate the compliance of the two drugs by investigating the clinical application of the two drugs in the prevention of deep vein thrombosis in lower extremity after major orthopedic surgery.Methods：Through questionnaire,observation of the patients during hospitalization and telephone visits for the discharged patients etc.,160 cases of elderly patients with intertrochanteric fracture were analyzed in the use of two kinds of drug usage and compared the efficacy,safety,and compliance.Results：Of the 160 patients who received the questionnaire,34 did not accept rivaroxaban,and 97 patients did not accept low molecular heparin.The compliance of the two groups was statistically significant（P0.05）.120 cases of patients using the rivaroxaban had 13 cases of the adverse reactions such as nausea,vomiting.27 Of the 40 cases of patients with low-molecular-weight heparin had adverse reactions such as happened scleroma,violet scar.Comparison between the two groups had statistical significance（P0.05）.Through the analysis and observation of the patients＇ hospitalization,the two groups showed no statistically significant difference in efficacy and safety（P0.05）.Conclusion：Rivaroxaban,as an oral anticoagulant,is easy to take,with little side effects and high patient compliance.In terms of efficacy and safety,the anticoagulation effect of rivaroxaban is comparable to that of low molecular heparin,which can be used as a routine treatment for the prevention of deep venous thrombosis of lower extremity after surgery.