利伐沙班与低分子肝素用于膝骨性关节炎关节置换术后预防下肢深静脉血栓中的效果

The Effect of Rivaroxaban and Low Molecular Weight Heparin in the Prevention of Deep Vein Thrombosis of Lower Limbs after Knee Osteoarthritis Joint Replacement

目的对膝骨性关节炎关节置换术患者应用利伐沙班与低分子肝素预防下肢深静脉血栓的效果进行探究。方法选择该院2019年1月—2020年1月收治的实施膝骨性关节炎关节置换术的患者100例作为该次研究纳入的研究对象,按照随机数字表法将其划分为甲组和乙组,每组各有50例。在对所有患者实施基本治疗以及物理预防下肢深静脉血栓治疗的基础上,采用低分子肝素治疗乙组患者,采用利伐沙班片治疗甲组患者。对比两组患者的治疗效果。结果甲组患者的下肢深静脉血栓发生率为0.0%明显低于乙组12.0%,差异有统计学意义(χ^(2)=5.327,P<0.05);甲组患者的D-D(419.5±102.7)μg/L、PT(10.3±1.2)s、APTT(28.1±2.3)s明显优于乙组(536.8±146.2)μg/L、(15.9±2.5)s、(33.8±2.8)s,差异有统计学意义(t=3.522、3.691、3.537,P<0.05);甲组的不良反应率为6.0%与乙组8.0%比较,差异无统计学意义(χ^(2)=0.175,P>0.05)。结论针对膝骨性关节炎关节置换术患者应用利伐沙班治疗可以有效地预防下肢深静脉血栓,控制其血液的高凝状态,而且具有较少的不良反应,安全性很高。

Objective To explore the effect of using rivaroxaban and low molecular weight heparin to prevent deep vein thrombosis of the lower extremities in patients with knee osteoarthritis and joint replacement.Methods 100 patients undergoing knee osteoarthritis joint replacement surgery in the hospital were selected as the research objects included in this study.The selected time period was from January 2019 to January 2020,and they were divided according to the random number table method:group A and group B,with 50 cases in each group.On the basis of basic treatment for all patients and physical prevention of deep vein thrombosis of the lower extremities,low-molecular-weight heparin was used to treat group B patients,and rivaroxaban tablets were used to treat group A patients.Compared the treatment effect of the two groups of patients.Results The incidence of deep vein thrombosis in group A patients was 0.0%significantly lower than that in group B 12.0%,the difference was statistically significant(χ^(2)=5.327,P<0.05);group A patients'DD(419.5±102.7)μg/L,PT(10.3±1.2)s,APTT(28.1±2.3)s was significantly better than group B(536.8±146.2)μg/L,(15.9±2.5)s,(33.8±2.8)s,the difference were statistically significant(t=3.522,3.691,3.537,P<0.05).The adverse reaction rate of group A was 6.0%compared with 8.0%of group B,the difference was not statistically significant(χ^(2)=0.175,P>0.05).Conclusion The application of rivaroxaban for knee osteoarthritis patients with joint replacement can effectively prevent deep vein thrombosis of the lower extremities,control the hypercoagulable state of their blood,and has fewer adverse reactions and was highly safe.