阿哌沙班与低分子肝素预防髋、膝关节置换术后下肢静脉血栓的效果比较

Comparison of the Efficacy of Apixaban and Low Molecular Weight Heparin in Preventing Lower Extremity Venous Thrombosis after Hip and Knee Arthroplasty

目的 对比探讨髋、膝关节置换术后采用低分子肝素与阿哌沙班在预防下肢静脉血栓的效果。方法 方便选择2019年1月—2020年12月于该院接受髋、膝关节置换术治疗的患者88例,根据单双号法将患者分为观察组(单号,44例)与对照组(双号,44例),对照组术后采用低分子肝素,观察组术后采用阿哌沙班,检测对比两组患者治疗前后凝血功能指标[活化部分凝血酶原时间(APTT)、部分凝血酶原时间(PT)、血小板计数(PLT)、纤维蛋白原(FIB)]变化,观察统计两组患者术后发生下肢深静脉血栓及并发症发生的总概率。结果 两组患者治疗前凝血功能指标差异无统计学意义(P>0.05),治疗后观察组患者APTT、PT、PLT均低于对照组,FIB高于对照组,差异有统计学意义(P<0.05)。观察组患者术后发生下肢深静脉血栓的概率2.27%低于对照组,差异有统计学意义(χ^(2)=4.456,P<0.05),两组患者并发症总发生率比较差异无统计学意义(P>0.05)。结论 患者接受髋、膝关节置换术治疗后采用阿哌沙班治疗能够有效预防下肢静脉血栓问题,调节患者凝血功能,且安全性理想,提倡运用推广。

Objective To compare the effects of low molecular weight heparin and apixaban in preventing lower extremity venous thrombosis after hip and knee arthroplasty.Methods A total of 88 patients who received hip and knee arthroplasty in the hospital from January 2019 to December 2020 were conveniently selected,and the patients were divided into observation group(odd number,44 cases) and control group(even number,44 cases) according to the odd and even number method,the control group was given low molecular weight heparin after operation,and the observation group was given apixaban after operation.The changes of coagulation function indexes [activated partial prothrombin time(APTT),partial prothrombin time(PT),platelet count(PLT),fibrinogen(FIB)] before and after treatment in the two groups of patients were detected and compared.The total probability of postoperative deep venous thrombosis and complications in the two groups were observed and counted.Results There was no statistically significant difference in the coagulation function indexes between the two groups before treatment(P>0.05).After treatment,the APTT,PT,PLT in the observation group were lower than those in the control group,the FIB were higher than those of the control group,and the difference was statistically significant(P<0.05).The probability of postoperative deep vein thrombosis in the observation group was 2.27% lower than that in the control group,and the difference was statistically significant(χ^(2)=4.456,P<0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P >0.05).Conclusion Apixaban can effectively prevent lower extremity venous thrombosis and regulate the coagulation function of patients after hip and knee arthroplasty,and the safety is ideal,and it is recommended to use and promote.