利伐沙班与低分子肝素对髋关节置换患者凝血功能的影响

Effects of rivaroxaban and low-molecular-weight heparin on coagulation function in patients with hip replacement

目的对比观察利伐沙班与低分子肝素对髋关节置换患者凝血功能的影响。方法选取上海交通大学附属第一人民医院松江分院2019年行髋关节置换术治疗的90例患者作为研究对象,采用随机数余数分组法分为低分子肝素组(45例)和利伐沙班组(45例),低分子肝素组患者采用低分子肝素治疗,利伐沙班组患者采用利伐沙班治疗,对两组患者凝血功能、失血量和术后引流量、并发症发生率进行比较。结果利伐沙班组患者失血量和术后引流量与低分子肝素组比较,差异均无统计学意义(P>0.05);两组患者术前和术后5周凝血功能指标比较,差异均无统计学意义(P>0.05);两组患者术后5周凝血功能指标均较同组术前提高,差异均有统计学意义(P<0.05);利伐沙班组患者并发症发生率为2.22%,低于低分子肝素组的11.11%,差异有统计学意义(P<0.05)。结论利伐沙班与低分子肝素均有助于改善髋关节置换患者的凝血功能,但利伐沙班在降低并发症发生率方面效果更佳,值得临床推广使用。

Objective To compare the effects of rivaroxaban and low-molecular-weight heparin on coagulation function in patients with hip replacement.Methods A total of 90 patients who underwent hip arthroplasty in First Affiliated Hospital of Shanghai Jiao Tong University Songjiang Branch Institute in 2019 were selected as the research subjects.They were divided into the low-molecular-weight heparin group(45 cases)and the rivaroxaban group(45 cases)by random number remainder grouping method.The low-molecular-weight heparin group was treated with low-molecular-weight heparin,and the rivaroxaban group was treated with rivaroxaban.The coagulation function,blood loss,postoperative drainage volume,and complication rate were compared between the two groups.Results There was no significant difference in blood loss and postoperative drainage volume between the rivaroxaban group and the low-molecular-weight heparin group(P>0.05).There was no significant difference in blood coagulation function indexes before the operation and 5 weeks after the operation in both groups(P>0.05),but the blood coagulation function indexes at 5 weeks after the operation were increased compared with those before the operation,and the differences were statistically significant(P<0.05).The incidence rate of complications in the rivaroxaban group was 2.22%,which was lower than 11.11%in low-molecular-weight heparin group,and the difference was statistically significant(P<0.05).Conclusion Both rivaroxaban and low-molecular-weight heparin can improve coagulation function in patients with hip replacement.However,rivaroxaban is more effective in reducing the incidence of complications and is worthy of popularization in future clinical work.