髋关节置换术后不同给药周期利伐沙班预防下肢深静脉血栓的效果及安全性分析

Analysis the effect and safety of different administration periods Rivaroxaban in preventing deep venous thrombosis of lower extremities after hip arthroplasty

目的分析不同给药周期利伐沙班在预防髋关节置换术后下肢深静脉血栓中的效果与安全性。方法选取2016年1月~2018年6月在我院行髋关节置换术的88例患者作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组各44例。两组患者均由同一组医护人员进行手术。术后对照组给予利伐沙班口服,1片/次,在硬膜外腔导管拔出后6h开始给药,给药周期为5周。观察组给药方法、给药剂量同对照组,给药周期为2周。比较两组患者下肢深静脉血栓发生率、术后引流量、术后瘀斑面积、凝血功能指标、安全性指标及服药依从性。结果两组的下肢深静脉血栓发生率、术后引流量、术后瘀斑面积、纤维蛋白原(Fbg)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)及D-二聚体(D-D)水平比较,差异无统计学意义(P>0.05)。两组患者治疗后均未出现血常规、尿常规、便常规及肝肾功能异常;两组出血≥5min的事件发生率比较,差异无统计学意义(P>0.05)。观察组的服药依从性得分高于对照组,差异有统计学意义(P<0.05)。结论髋关节置换术后利伐沙班给药2周与给药5周均具有较好的预防下肢深静脉血栓作用,可有效改善患者凝血功能,给药2周不增加不良反应发生率,可明显提高服药依从性,临床可根据患者的具体情况选择给药周期。

Objective To analyze the effect and safety of different administration periods Rivaroxaban in preventing deep venous thrombosis of lower extremities after hip arthroplasty. Methods Eighty-eight patients who underwent hip arthroplasty in our hospital from January 2016 to June 2018 were selected as the study subjects, they were divided into observation group and control group by random number table method, 44 cases in each group. Two groups of patients were operated on by the same group of medical staff. The control group was given Rivaroxaban orally, one tablet per time, 6 hours after the extubation of epidural catheter, and the administration period was 5 weeks. The method and dose of administration in the observation group were the same as those in the control group, and the period of administration was 2 weeks. The incidence of deep venous thrombosis in lower extremities, postoperative drainage, area of blood stasis, coagulation function, safety and drug compliance were compared between the two groups. Results There were no significant differences in the incidence of deep venous thrombosis, drainage volume, area of blood stasis, fibrinogen (Fbg), thrombin time (TT), prothrombin time (PT), activated partial thrombin time (APTT) and D-dimer (D-D) levels between the two groups (P>0.05). There were no abnormal blood routine, urine routine, stool routine and liver and kidney function after treatment in both groups. There was no significant difference in the incidence of bleeding (≥5 minutes) between the two groups (P>0.05). The score of compliance in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). Conclusion Rivaroxaban can prevent deep venous thrombosis of lower extremities after hip replacement for 2 weeks and 5 weeks. It can effectively improve the coagulation function of patients. It does not increase the incidence of adverse reactions after 2 weeks of administration, and can significantly improve the compliance of taking medicine. The administration cycle can be selected according to the specific conditions of patients.