利伐沙班预防人工全髋关节置换术后发生下肢深静脉血栓形成的作用

Role of rivaroxaban in preventing deep venous thrombosis of lower limbs after total hip replacement

目的探讨利伐沙班预防人工全髋关节置换术(THA)后发生下肢深静脉血栓(DVT)形成的作用。方法选取本院收治的178例THA患者,用随机数字表法将患者分为试验组和对照组各89例;术后24 h开始,试验组口服利伐沙班10 mg·d-1,对照组皮下注射低分子量肝素钙5000 U·d-1,疗程均为2周。对比2组的凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体和DVT发生率。结果治疗后,试验组和对照组的D-二聚体分别为(1338.13±302.70)和(1548.42±344.05)g·L^-1,组间比较差异有统计学意义(P<0.05)。这2组的PT分别为(12.68±0.81)和(12.81±0.75)s;这2组的APTT分别为(29.80±4.10)和(30.61±3.85)s;这2组的Fib分别为(3.67±0.77)和(4.10±0.83)g·L^-1,组间比较差异均无统计学意义(均P>0.05)。试验组和对照组患者的DVT发生率分别1.12%(1例/89例)和4.49%(4例/89例),组间比较差异无统计学意义(P>0.05)。结论利伐沙班预防THA后发生下肢DVT的效果与低分子肝素差异不大,但是对于凝血功能的调节效果更明显。

Objective To explore the role of rivaroxaban in preventing the formation of deep venous thrombosis(DVT)in lower limbs after total hip replacement(THA).Methods THA patients admitted to our hospital were selected and divided into treatment group and control group by random number table method,with 89 cases in each group.The treatment group began oral rivaroxaban 10 mg·d-124 h after surgery,and the course of treatment was two weeks;the control group began subcutaneous injection of low-molecular-weight heparin calcium 5000 U·d-124 h after surgery for two weeks.The incidence of prothrombin time(PT),partially activated thrombin time(APTT),fibrinogen(Fib),D-dimer and DVT were compared between the two groups.Results After treatment,the D-dimer in treatment group and control group were(1338.13±302.70)and(1548.42±344.05)g·L^-1,respectively;and the difference was statistically significant(P<0.05).The PT in the two groups were(12.68±0.81)and(12.81±0.75)s;the APTT in the two groups were(29.80±4.10)and(30.61±3.85)s;the Fib in the two groups were(3.67±0.77)and(4.10±0.83)g·L^-1,the differences of the factors were not statistically significant(all P>0.05).The incidence of DVT in treatment group and control group were 1.12%(1 case/89 cases),4.49%(4 cases/89 cases),respectively;the differences was not statistically significant(P>0.05).Conclusion The effect of rivaroxaban on preventing lower limb DVT after THA is not much different from that of low molecular weight heparin,but the effect of regulating coagulation function is more obvious.