阿哌沙班与低分子肝素预防骨折术后血栓效果比较

Comparison of efficacy in preventing postoperative thrombosis:apixaban vs low⁃molecular⁃weight heparin in fracture patients

目的 比较使用阿哌沙班和低分子肝素预防股骨干骨折术后下肢深静脉血栓的效果。方法 将2020年1月至2021年12月于上海市嘉定区南翔医院骨科行手术治疗的82例股骨干骨折患者随机分为两组,根据术后预防下肢深静脉血栓不同用药进行分组,每组各41例,对照组使用低分子肝素治疗,观察组使用阿哌沙班治疗,对比两组的凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血时间(TT)、纤维蛋白原(FIB)、血小板(PLT)]、其他血生化指标[γ-谷氨酰转肽酶(GGT)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]、血液流变学指标[血浆黏度(PV)、全血高切黏度(WBHSV)、全血低切黏度(WBLSV)、红细胞压积(PCV)]、下肢深静脉血栓及不良反应。结果 治疗后两组PT、APTT、TT、FIB、PLT、GGT、AST、ALT、PV、WBHSV、WBLSV和PCV比较差异无统计学意义(P>0.05);观察组下肢深静脉血栓发生率为4.88%,明显低于对照组的24.39%,差异有统计学意义(P<0.05);观察组和对照组不良反应发生率分别为4.88%、9.76%,两组比较差异无统计学意义(P>0.05)。结论 阿哌沙班治疗术后下肢深静脉血栓的效果更好,安全性较高,可优先采用。

Objective To compare the efficacy of apixaban and low molecular weight heparin in the treatment of lower limb deep vein thrombosis following femoral shaft fracture surgery.Methods From Jan-uary 2020 to December 2021,according to applying different medication to prevent lower extremity deep vein thrombosis,orthopedic surgery treatment of 82 cases of femoral shaft fracture patients in our hospital were ran-domly divided into two groups,41 cases in each group.The control group used low molecular weight heparin treatment,while the observation group used apixaban treatment.The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),platelet count(PLT),γ-glutamyl trans-ferase(GGT),aspartate aminotransferase(AST),alanine aminotransferase(ALT),plasma viscosity(PV),whole blood high shear viscosity(WBHSV),whole blood low shear viscosity(WBLSV),packed cell volume(PCV),lower limb deep vein thrombosis,and adverse reactions were compared between the two groups.Results There were no significant differences in PT,APTT,TT,FIB,PLT,GGT,AST,ALT,PV,WBHSV,WBLSV,and PCV between two groups after treatment(P>0.05).The incidence rate of lower ex-tremity deep vein thrombosis in the observation group was 4.88%,which was significantly lower than that in the control group(24.39%),with a statistically significant difference(P<0.05).The incidence of adverse reactions in the observation group and control group was 4.88%and 9.76%,respectively,with no statistically significant difference(P>0.05).Conclusion Apixaban has shown superior effectiveness and higher safety in the treat-ment of postoperative deep venous thrombosis in the lower limbs,therefore it should be given priority.